ObjectiveTo systematically review the efficacy of remnant-preserving anterior cruciate ligament (ACL) reconstruction versus standard ACL reconstruction by arthroscopy. MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 11, 2015), CBM, CNKI, VIP and WanFang Data were electronically searched to collect randomized controlled trials (RCTs) about remnant-preserving ACL reconstruction versus standard ACL reconstruction by arthroscopy from inception to Nov. 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 5 RCTs involving 295 knees were included. The results of meta-analysis showed that: KT-1000 measurement and tibial tunnel enlargement at final follow-up in the remnant-preserving ACL reconstruction group were less than that of the standard ACL reconstruction group with significant difference (MD=-0.36, 95%CI -0.63 to -0.10, P=0.007; MD=-0.44, 95%CI -0.71 to -0.16, P=0.002). There were no significant differences between both groups in rate of negative pivot shift test, rate of negative Lachman test, Lysholm scores, IKDC subjective scores and joint range of motion (all P values >0.05). ConclusionArthroscopic remnant-preserving ACL reconstruction can prevent the tibia tunnel enlargement and improve the stability of the knee joint postoperatively, but cannot improve the short-term postoperative functional scores. Due to the limited quality and quantity of the included studies, more large-scale and high quality RCTs are needed to verify the above conclusion.