The purpose of this study was to assess the clinical results of arthroscopic double-bundle posterior cruciate ligament (PCL) reconstruction using double cross-pin fixation on the tibial side. Twenty-two patients who underwent PCL reconstruction using an Achilles tendon allograft with double cross-pins for tibial fixation were evaluated. There were 19 men and 3 women with mean age 36 years (range 18-59), and the average follow-up period was 33 months (range 24-60). Preoperative and postoperative knee functions were evaluated in all patients using Lysholm knee scores, the 2000 International Knee Documentation Committee (IKDC) grades, and Tegner activity scores. Median Lysholm knee scores were 64 (50-75) preoperatively and 88 (82-96), 89.9 +/- 6.5 postoperatively (P < 0.001). Median side-to-side differences, determined using Telos stress radiographs, were 11 mm (8-14) preoperatively, and 3 mm (1-7) at final follow-up visits (P < 0.01). According to KT-2000 arthrometer measurements, mean side-to-side differences were 11 mm (8-13) preoperatively and 3 mm (1-6, P < 0.01) at final follow-up visits (P < 0.01). Preoperatively the 2000 IKDC evaluation system rated all patients as abnormal or severely abnormal (C or D), and at final follow-up visits, 20 patients (88%) were rated as normal or nearly normal (A or B) and 2 patients (12%) were rated as abnormal (C). Median preinjury and preoperative Tegner scores were 7 (range 5-9) and 3 (range 2-5), respectively, and the mean postoperative Tegner score was 6 (range 3-9). There were no intraoperative or postoperative complications. Our study shows that arthroscopic double-bundle PCL reconstruction using an Achilles allograft with double cross-pins for tibial fixation provides satisfactory clinical results given a mean follow-up of 33 months. We believe that this method provides a reliable alternative technique of PCL reconstruction.