Summary: The posterior mini-incision hamstring graft harvest approach for anterior cruciate ligament reconstruction is introduced. The harvest incision is placed over the medial popliteal fossa. This facilitates identification and differentiation of the semitendinosus (ST) and gracilis (Gr) tendons. It also facilitates sectioning of the accessory semitendinosus and other tendinous cross-connections to prevent the tendons from being cut too short for use by the tendon stripper. Clinical results in over 200 patients showed satisfactory harvest in each case with no complications. Cadaveric dissection showed no neurovascular danger. Cosmesis was superior with high patient satisfaction and allowed the anterior fixation incision, as well as the posterior harvest incision, to be one inch or less in size.