Double-bundle ACL reconstruction has been proposed to restore normal anatomy and kinematics of the knee, however non-anatomic tunnel placement may lead to less than optimal clinical outcomes. The purpose of this study was to determine the relationship between tunnel placement and clinical outcomes following double-bundle ACL reconstruction. Anatomic tunnel placement will be related to better clinical outcomes. Methods: The tunnel positions for 67 subjects that underwent double-bundle ACL reconstruction were measured on post-operative radiographs. Forty males and 27 females were included in this study. Their average age was 27.39 ± 11.04 years and the average length of follow-up was 2.07 ± 0.52 years. Femoral length was measured as the distance from the most posterior contour of the lateral femoral condyle parallel to Blumensaat's line and femoral height was measured as the perpendicular distance from Blumensaat's line. Tibial depth was measured as the distance from the most anterior aspect of the tibia on the sagittal view and tibial width was measured as the distance from the medial tibial plateau on the AP view. All measurements of tunnel position were normalized to express the position as the percentage of medial-lateral and anterior-posterior distance on the tibial plateau and the proximal-distal and anterior-posterior position on the femoral condyle. The relationships between tunnel position and clinical outcomes including range of motion, manual and instrumented laxity and patient-reported outcome were analyzed. On average, the center of the femoral AM insertion of the ACL was located at 26.3% of the femoral length and at 17.6% of the femoral height. The center of the femoral PL insertion was located at 40.2% of the femoral length and 40.8% of the femoral height. The center of the tibial AM and PL insertions were located at 34.8% and 52.6% of the AP tibial length and at 43.2% and 47.2% of the tibial width, respectively. A higher and more anterior position of the AM femoral tunnel was associated with a greater perception of instability. Lower position of the PL femoral tunnel was associated with higher Activities of Daily Living Scores. More posterior placement of the AM tibial tunnels was associated with a greater KT-1000 side to side difference. Our results indicate that placing the AM and PL femoral tunnels closer to their anatomic insertion sites leads to improved clinical outcomes. The results also suggest that more anatomic placement of the AM tibial tunnel better restores normal AP knee laxity.