129 patients with an anterior cruciate ligament tear scheduled for anatomic single-bundle reconstruction were randomized to receive either a six-stranded semitendinosus and gracilis (hamstring) allograft (6-strand HT) or bone-patellar-tendon-bone (BPTB) allograft. The purpose of this study was to determine if the 6-strand HT group demonstrated significantly better rotational and anterior knee stability compared to the BPTB group over a 4-year follow-up. Results over the duration of follow-up to 4 years demonstrated significantly better pivot-shift test scores and KT-1000 arthrometer measures in the 6-strand HT group compared to the BPTB group. Lachman test scores, patient-reported functional measures, and knee range of motion deficit did not significantly differ between groups.