105 patients scheduled for anatomic anterior cruciate ligament (ACL) reconstruction with a hamstring autograft were randomized to an anatomic double-bundle or single-bundle reconstruction. The purpose of this study was to test the hypothesis that a double-bundle reconstruction would offer greater knee stability postoperatively when measured using the pivot-shift test over a 5 year follow-up period, compared with single bundle reconstruction. The results demonstrated no significant differences between groups in the rate of positive pivot-shift tests through follow-up, nor in any other secondary outcome of knee stability/laxity, patient-reported function, or functional performance.