Objective <p>Although platelet-rich plasma (PRP) has been applied in anterior cruciate ligament reconstruction (ACLR) to promote recovery, the time-dependent efficacy of PRP on postoperative pain, function, and joint stability remains controversial. This study aims to evaluate the clinical effects of PRP at various follow-up intervals within two years after ACLR through a time-stratified meta-analysis.</p> Methods <p>A comprehensive literature search was systematically performed across PubMed, Embase, the Cochrane Library, and Web of Science databases. Outcome measures included the Visual Analogue Scale (VAS), Lysholm score, International Knee Documentation Committee (IKDC) score, Tegner activity score, and KT-1000 arthrometer readings. Standardized mean differences (SMDs) with corresponding 95% confidence intervals (CIs) were calculated. Sensitivity analyses were conducted to assess the stability and reliability of the findings.</p> Results <p>A total of 12 randomized controlled trials (RCTs) involving 599 ACLR patients were included. The analysis showed that PRP significantly improved VAS scores at 6 months postoperatively (SMD = -0.36, 95% CI: -0.62 to -0.10, <i>P</i> = 0.006), but no significant improvements were observed at 3, 12, or 24 months (<i>P</i> &gt;0.05). Regarding knee function, there were no significant differences between groups in IKDC score, Lysholm score, or Tegner score at any of the assessed time points (3, 6, and 12 months) (<i>P</i> &gt;0.05). Additionally, PRP significantly improved KT-1000 scores (SMD = -0.51, 95% CI: -0.82 to -0.19, <i>P</i> = 0.001).</p> Conclusions <p>PRP may alleviate pain and improve knee joint stability in the short term (at 6 months post-ACLR), but it offers no significant benefits for mid- to long-term pain control or functional recovery. Future studies with standardized PRP preparation protocols, extended follow-up durations, and larger sample sizes are needed to further validate its clinical value.</p>