Although tourniquets are used commonly during anterior cruciate ligament (ACL) surgery, little data are available regarding their effects on postoperative function. This retrospective study evaluated 94 patients who had an arthroscopically assisted, autogenous bone-patellar ligament-bone ACL reconstruction between 1988 and 1991 at the San Diego Kaiser Hospital. A tourniquet was used in 48 patients (T+ group). No tourniquet was used in 46 patients (T- group). The surgical and postoperative protocols were identical for the two groups. There were no bleeding complications. There was no significant difference in anesthesia time between the two groups. This study has shown that ACL surgery can be performed expeditiously without a pneumatic tourniquet. Quadriceps strength recovery after surgery was less in the T+ group at 12 weeks after surgery, but there was no significant difference between the groups 52 weeks after surgery. Difference in thigh girth was greater in T+ group 6 and 12 weeks after surgery, but there was no significant difference between the groups 52 weeks after surgery.