The aim of this study was to evaluate the results after arthroscopic anterior cruciate ligament reconstruction using a bone-patellar tendon-bone graft in 99 patients, who were followed up prospectively for four to seven years. The pre-injury Tegner activity level was 7 compared with 5 at the four- to seven-year follow-up (P<0.0001). The preoperative Lysholm score was 74.5 points. At the two-year follow-up, the Lysholm score was 95 points, while it was 90 points at the four- to seven-year follow-up (P<0.0001 preoperative vs two years and preoperative vs four to seven years and P<0.0005 two years vs four to seven years). Using the IKDC evaluation system, 80% of the patients were classified as normal or nearly normal and 20% as abnormal or severely abnormal at the final follow-up. The KT-1000 laxity measurements revealed a side-to-side difference of 2.9 mm preoperatively, 0.6 at two years and 1.0 mm at four to seven years. Twenty-six patients underwent additional surgery during the follow-up period. The results after arthroscopic reconstruction of the anterior cruciate ligament appear to be satisfactory both at the short- and the medium-term follow-ups, but there appears to be some deterioration between the two-year and the four- to seven-year follow-up.