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Purpose: The ideal treatment for patients presenting with bilateral anterior cruciate ligament (ACL) deficiency remains controversial. The purpose was to evaluate cost and functional results after one-stage bilateral ACL reconstruction using hamstring tendon autograft. Methods: This prospective study evaluated the mid-termfunctional outcome of 7 patients (14 knees) who had undergone one-stage bilateral ACL reconstruction. Results: The median length of hospital stay was 4 (3-5) days. The duration of rehabilitation process in patients with bilateral ACL reconstruction was 6-8weeks. The mean Lysholm scorewas 93 (90-95), IKDC score 78.7 (74.7-82.75), and Tegner activity score level 5. The median time to return to full-timework and to full sports was 9 weeks and 8 months respectively. 6 patients (85.7%) in the study group returned to their pre-injury level of activity. Conclusions: Mid-term clinical results suggested that one-stage bilateral ACL reconstruction using hamstring tendon autograft is clinically effective. For patients presenting with bilateral ACL-deficient knees, one-stage bilateral ACL reconstruction is reproducible, cost effective and does not compromise functional results. [ABSTRACT FROM AUTHOR]