This systematic review and meta-analysis included 13 studies with 989 patients who underwent single-bundle anterior cruciate ligament reconstruction using either the transtibial (TT, n=486) or anteromedial (AM, n=503) technique. Outcomes assessed included objective and subjective IKDC scores, Lysholm scores, Tegner activity scale, anterior tibial translation, pivot-shift test, and graft failure rates. The AM technique demonstrated significantly better objective IKDC scores, Lysholm scores, and reduced residual laxity (p < 0.001) compared to TT. However, subjective IKDC scores, Tegner activity scale, and graft failure rates were similar between groups. The findings suggest that the AM technique offers superior knee stability and clinical outcomes without a higher graft failure risk.