Autograft hamstring harvest continues to be one of the most technically demanding aspects of arthroscopically-assisted ACL reconstruction [1Allum R. JBJS Br. 2003; Google Scholar]. The fascial attachments between the semitendinosus and gracilis and from the semitendinosus to the medial head of the gastrocnemius have been previously described as threats to premature amputation [2Solman Jr, C.G. Orthop Clin North Am. 2003; PubMed Google Scholar]. The fascial bands are believed to become continuous with the posterior crural fascia eight to 10 cm from the pes anserine insertion [2Solman Jr, C.G. Orthop Clin North Am. 2003; PubMed Google Scholar]. An in vitro study [3Ferrari J.D. Orthop Rev. 1991; PubMed Google Scholar] found that the mean distance from the semitendinosus insertion to the tendinous reflection of its fascial connection was 7 cm. These prior efforts, however, did not quantify the extent of this fascial attachment to the semitendinosus. Additionally similar fascial attachments to the gracilis and the anatomical morphometry of the sartorius fascial band have yet to be described. The objectives of this study were to describe: (1) the anatomic morphometry of the sartorius, gracilis and semitendinosus fascia band attachments in a cadaver model; (2) an intraoperative technique to assess the level of dissection of these attachments. Knowledge of these fascial connections is crucial to avoid premature amputation during autologous hamstring harvest for ACL reconstruction. Seven fresh-frozen cadaveric lower limbs from five female donors (average age 64 years) were used. The medial side of the knee was exposed and the sartorius fascia incised. The gracilis and semitendinosus tendons were released distally from the tibia. A 1.1mm K-wire, drilled into the tibia at the medial edge of the patella tendon, marked the center of this insertion site. The gastrocnemius fascia band attachments to the sartorius (SFB), gracilis (GFB) and semitendinosus (STFB) were identified. Five measurements were independently made by three examiners: SFB width, GFB width, STFB width, wire to distal edge of GFB, and wire to distal edge of STFB. The sartorius (SFB) and semitendinosus fascia bands (STFB) were created by firmly adherent fascia overlying the medial head of the gastrocnemius. The gracilis fascial band (GFB) acted as a sling formed by the sartorius fascial band (SFB) and gastrocnemius fascia attachments. The average distances were 68.1±8.0mm (SFB width), 44.3±9.3mm (GFB width), 57.5±15.7mm (STFB width), 52.9±12.1mm (wire to GFB), and 47.9±9.7mm (wire to STFB). Mean coefficients of variation between examiners ranged 9 to 15%. The width and distal most edge of the hamstring fascial band attachments have been quantified. Circumferential release of the fascial connections to the gracilis and semitendinosus is the key to preventing premature amputation. The competency of the fascial attachments to the gracilis and semitendinosus can be visually assessed intraoperatively; when tension is applied to the free ends of these tendons, the skin, which overlies their respective fascial attachments, dimples. The senior author refers to this as the “pucker sign.” Following a complete circumferential release of these fascial attachments this pucker sign is eliminated. Subsequently the tendon stripper may be used without risk of premature amputation.