200 patients scheduled for unilateral arthroscopic anterior cruciate ligament (ACL) reconstruction were randomized to receive a tourniquet (n=100) or no tourniquet (n=100) during the procedure. Primary outcomes of interest included intraoperative visualization, operative time, and sterile saline consumption. Secondary outcomes of interest included blood loss, pain, opioid consumption, limb swelling, functional scores, and graft healing. Outcomes were assessed up to 12 months post-operation. Results revealed significantly better intra-operative visualization, less intra-operative blood loss, shorter operative time, and less sterile saline consumption in the tourniquet group. No differences in pain, opioid consumption, swelling, functional scores or graft healing were observed between the two groups.