Purpose <p>Evaluation of tunnel widening and functional outcome parameters in conventional ACL reconstruction with and without accessory tibial fixation.</p> Methods <p>43 patients who underwent hamstring tendon ACL reconstruction were assessed retrospectively with a CT scan for tunnel widening and were compared to intra-operative drilling diameter. The functional assessment comprised of 2000 IKDC subjective knee score, Lysholm score, pivot shift test, and side-to-side difference in knee laxity.</p> Results <p>22 patients without accessory tibial fixation (Group A) and 21 patients with accessory tibial fixation (Group B) with a minimum follow-up of 29&#xa0;months were compared. The clinical outcome parameters were comparable between the groups. On the rank-sum test, the percentage change in tunnel diameter did not exhibit any significant difference in the articular(F1) and middle portion(F2) of the femoral socket (<i>P</i> = 0.39 and 0.86 for F1 and F2, respectively) as well as in the articular(T1) and middle portion(T2) of tibial tunnel (<i>P</i> = 0.07 and 0.87 for T1 and T2, respectively). 4 out of 21 Group B patients complained about hardware prominence.</p> Conclusion <p>Accessory tibial fixation has no benefits in terms of tunnel widening and clinical outcomes. Rather it may lead to hardware prominence.</p> <p><i>Level of evidence</i> III.</p>