We sought to determine how the status of the meniscus and articular cartilage observed at the time of anterior cruciate ligament reconstruction affects results at 5 to 15 years after surgery. Objective follow-up was obtained on 482 patients at a mean of 7.6 years after surgery. Subjective follow-up was obtained on 928 patients at a mean of 8.6 years after surgery. Patients with both menisci present had significantly better KT-1,000 arthrometer scores than did patients with any part of the medial or both menisci removed. Stepwise regression analyses determined that a partial or total medial or lateral meniscectomy and damaged articular cartilage significantly lowered the final subjective total score. Patients with both menisci present and normal articular cartilage had a mean subjective total score of 94, and 97% had normal or near normal radiographic ratings on a weightbearing 45 degrees posteroanterior radiographs. The overall International Knee Documentation Committee rating was normal or nearly normal for 204 of 235 patients (87%) with both menisci present, 52 of 74 patients (70%) with partial or total lateral meniscectomies, 71 of 113 patients (63%) with partial or total medial meniscectomies, and 36 of 60 patients (60%) with both menisci removed. We concluded that the long-term subjective and objective results of a successful anterior cruciate ligament reconstruction are affected by the status of the menisci and articular surface.