Background: Anatomical single bundle arthroscopic Anterior cruciate ligament (ACL) reconstruction has been the standard treatment for ACL injured patients. It is a minimally invasive procedure that allows the surgeon tounderstand the internal derangements of the knee joint. The purpose of Arthroscopic ACL reconstruction is to restore the normal kinematics of knee joint. The aim of the current study was evaluation of the results of anatomic single bundle anterior cruciate ligament reconstruction using hamstring tendon. Patients and methods: prospective clinical study was conducted in Orthopedic Department, Faculty of Medicine, Zagazig University, on 24 patients (18 males and 6 females with mean age 30.16±5.9) with chronic ACL tear treated with the hamstring tendon for reconstruction of the anterior cruciate ligament in all patients during the period from April 2020 to April 2021. Results: Grade of Lysholm score improved significantly postoperatively, where 17 patients were excellent, 5 patients were good, and 2 patients were fair. IKDC SCORE was improved from 45.83±7.46 preoperatively to 78.12±6.04 postoperatively. There were 19 patients without complication, 4 patients had superficial infection and 1 patient had deep infection. Conclusion: The anatomic anterior cruciate ligament reconstitution using hamstring tendon is more effective for reproducing the anatomy of the ACL and obtaining good clinical results, when it is done by accessory medial portal because the technique enables for a better view inside the knee and more obliquity of the reconstructed ACL when compared to the transtibial technique.