13 prospective clinical trials comprising of 1299 patients undergoing primary anterior cruciate ligament (ACL) reconstruction were reviewed. Patients were treated with either autograft or allograft tissue. Graft types included hamstring tendon, bone–patellar tendon–bone, gracilis tendon, and Achilles tendon, with both irradiated and non-irradiated allografts represented. The primary outcomes of interest included subjective and objective International Knee Documentation Committee (IKDC) scores, Lysholm score, Tegner activity score, Lachman test, and pivot shift test. Follow-up duration was at least 2 years across all included studies, with several trials reporting mid to long-term outcomes beyond five years. Overall, the results of the study revealed statistically significant differences favouring autografts for subjective IKDC scores, Tegner activity scores, pivot shift test results, and objective IKDC scores. However, no significant differences were observed for Lysholm scores or Lachman test results. The magnitude of these differences was small and unlikely to translate into clinically meaningful superiority of one graft type over the other.