Anterior cruciate ligament (ACL) injuries are among the most prevalent knee injuries, often requiring surgical reconstruction to restore knee stability and function. Objectives: In this study we aimed to investigate the rate of re-rupture of the anterior cruciate ligament after tibial strut- preserving ACL reconstruction. Methodology of the study: This prospective cohort study was conducted at Sahiwal International hospital, from November 2022 to November 2023. The research included 98 patients who underwent anterior cruciate ligament (ACL) reconstruction surgery using the tibial strut-preserving technique. Data were collected including preoperative assessments, medical history, physical examinations, and imaging studies such as magnetic resonance imaging (MRI) or computed tomography (CT) scans. Postoperative evaluations were conducted at regular intervals to monitor patient outcomes, including functional outcomes, graft integrity, and the occurrence of re-ruptures