This study compares anatomy and tunnel placement during double-bundle procedures. Double-bundle anterior cruciate ligament (ACL) reconstruction reproduces both the anteromedial and posterolateral bundles. Thirty-six knees from cadavers were used for anatomic study, and 38 navigated double-bundle ACL reconstructions were evaluated for tunnel placements. With the exception of femoral tunnels of anteromedial bundles, all tunnel placements were in accordance with the anatomic measurements of the native ACL. The investigators concluded that incorporating ACL anatomic information into navigation systems would enhance double-bundle procedures.