We compared magnetic resonance imaging findings with knee stability measurements in a group of 52 patients 5 to 7 years after repair of an acute anterior cruciate ligament rupture. The patients underwent one of three surgical procedures: nonaugmented repair using the Palmer technique, repair with synthetic augmentation, and repair with biologic augmentation. The appearances of the menisci, subchondral bone, and cartilage were also assessed. Of the patients with clinically stable knees in the nonaugmented repair group, the repaired ligament appeared to be present and intact in 54% (7 of 13) of the patients. In the group with the repair augmented with the ligament augmentation device, 33% (4 of 12) demonstrated repair integrity, whereas in the group with patellar tendon augmentation of the repair, 82% (14 of 17) of the patients with clinically stable knees had intact ligaments on magnetic resonance imaging. Twelve patients had new and complete ruptures of one of the menisci, nine of which occurred in unstable knees. Thirteen patients had subcortical bone changes in the femoral condyles. Eight of these knees had major degenerative cartilage changes overlying the bone changes. Magnetic resonance imaging signals in the repaired ligament augmented with the patellar tendon were highly predictive of clinical stability, but the integrity of the nonaugmented and ligament augmentation device-augmented anterior cruciate ligament repairs did not closely correlate with the clinical findings.