Seventy-four patients with anterior cruciate ligament (ACL) tears were randomized to receive double-bundle (DB) ACL reconstruction (n=36) or combined single-bundle (SB) ACL and anterolateral ligament (ALL) reconstruction (n=38). The primary outcome of interest was postoperative clinical stability of the knee, measured by range of motion (ROM) assessments, the Lachman test, pivot shift test, anterior translation on stress radiographs, and KT-2000 arthrometer readings. Patient reported outcomes included the Lysholm score, International Knee Documentation Committee score, and Tegner activity score. Graft evaluation outcomes of interest included graft continuity, assessed through postoperative magnetic resonance imaging (MRI) and second-look examinations. All outcomes were assessed up to 27.3 ± 4.2 months for the DB group and 27.2 ± 4.5 months for the SB + ALL group. Overall, the results of the study revealed that both DB and SB + ALL groups showed similar postoperative clinical, radiographic, and second-look arthroscopic outcomes, with excellent postoperative stability and clinical outcomes compared to preoperative measurements.