The purpose of this study is to compare the post-operative side-to-side laxity and short-term clinical outcomes of patients who received primary ACL repair with suturetape augmentation, acute ACL reconstruction with suture tape augmentation performed within 8 weeks of injury (ACLRacute), or ACL reconstruction (ACLR) beyond 8 weeks of injury. Following IRB approval, 100 patients were enrolled in this prospective trial: n=34 primary ACL repair with suture tape augmentation, n=33 ACL reconstruction performed within 8 weeks of injury (ACLRacute), and n=33 ACL Reconstruction (ACLR). Patients were allocated to ACL repair if a proximal avulsion was present with good tissue quality (Sherman type 1), confirmed by intraoperative diagnostic arthroscopy. Preoperative side-to-side AP knee laxity was assessed with KT-1000 arthrometer and patient-reported outcomes (PROs) including visual analog scale (VAS), Marx activity scale, Veterans RAND 12-item health survey (VR-12 physical & mental), Single Assessment Numeric Evaluation (SANE), Knee Injury and Osteoarthritis Outcome Score (KOOS) survey subscales, and range of motion (ROM) were collected. These objective and subjective measures were repeated at regular intervals post-operatively through 2 years. Minimal clinically important differences (MCID) calculations were performed assessing post-operative PRO changes at 2 years compared to preoperative. The average time from injury to surgery was 5.03±1.2 weeks for the ACL repair group, 5.09±0.74 weeks for the ACLRacute, and 43.22±33.5 weeks for the ACLR group. Postoperatively, the KT-1000 side-to-side laxity difference for 30lbs was determined to be 0.1±0.37, 95% CI: [-0.7,0.8] for ACL repair vs ACLR (p<0.0001), -0.8±0.35, 95% CI: [-1.5,-0.1] for ACLRacute vs ACLR (p<0.0001), and 0.8±0.40, 95% CI: [0.0,1.6] for ACL repair vs ACLRacute (p<0.0001). The data reveals ACL repair and ACLRacute are non-inferior to ACLR at 2-year follow-up. The post-operative difference from baseline for all PROs demonstrated improvement for all PROs. MRI at 1-year revealed tissue healing for the three ACL injury treatment groups. Patients who underwent ACL repair of proximal tears with suture tape augmentation or ACL reconstruction within 8 weeks from injury resulted in non-inferior side-to-side knee laxity, comparable PROs, and similar range of motion at 2-year follow-up, compared to ACL reconstruction.