Six randomized controlled trials were included in this meta-analysis comparing outcomes following single-bundle ACL reconstruction with remnant preservation versus debridement. Outcomes which were pooled and compared included knee laxity through the pivot shift and Lachman tests, the functional outcome on the International Knee Documentation Committee and Lysholm scores, the incidence of cyclops lesions, and tibial tunnel enlargement postoperatively. No statistically significant or clinically relevant differences in laxity or functional measures were found. Pooled data from two studies demonstrated lower tibial tunnel enlargement following remnant preservation versus remnant debridement, although heterogeneity was significant.