Background:The anterior cruciate ligament (ACL) is recognized as the most frequently injured ligament within the knee joint. The present study was conducted for comparing the outcome of Arthroscopic ACL reconstruction by PLT vs Semitendinosus graft. Materials & methods:A cohort of 40 patients diagnosed with anterior cruciate ligament (ACL) tears, confirmed through both clinical assessment and radiographic imaging, underwent arthroscopic ACL reconstruction. Of these patients, 20 received semitendinosus grafts, while the remaining 20 were treated with peroneus longus tendon grafts. All surgical procedures were performed under spinal or epidural anesthesia, utilizing a tourniquet, and the postoperative recovery was without complications. A uniform rehabilitation protocol was implemented for all patients following the ACL reconstruction. Postoperative outcome was evaluated using Lysholm score. Results:Mean age of the patients of Semitendinosus grafts group and PLT group was 38.3 years and 40.7 years respectively. Mean postoperative Lysholm score among patients of the Semitendinosus grafts group and PLT group was 91.3 and 93.7 respectively. Excellent results were seen in 85 percent of the patients of the semitendinosus group and in 90 percent of the patients of the PLT group. non-significant results were obtained while comparing outcome among patients of both the study groups. Conclusion:The semitendinosus muscle contributes to knee internal rotation and flexion strength. PLT also has significant tensile strength and the potential for regeneration post-replacement. Arthroscopy-assisted anterior cruciate ligament (ACL) reconstruction utilizing either a semitendinosus autograft or a peroneus longus tendon autograft result in enhanced knee stability, minimizes postoperative complications, and facilitates prompt rehabilitation.