Abstract：[Objective] To introduce the arthroscopic Posterior Cruciate Ligament reconstruction with the under-the-Anterior Cruciate Ligament(ACL) tibial guide insertion. [Methods] A retrospective study was conducted on 20 patients received arthroscopic PCL reconstruction in our Hospital from March 2016 to November 2018. All patients underwent the ligament reconstructed by under -the ACL tibial guide insertion techniques . Tibial tunnel locations were measured by postoperative vivo 3-dimensional computed tomography(3DCT)， Stress radiography of pre- and post-operation，the Lysholm score of knee function were used to evaluate. [Results] 3D-CT conducted postoperatively showed the good location of tibial tunel. All 20 patients were significantly improved the posterior laxity control compared with preoperation by stress radiography at 12 months postoperatively, from10.81±3.07mm to 3.86±1.10mm; The Lysholm score of knee function were significantly improved 38.75±14.52 to 93.70±4.23 points. At 2 years after surgery, internal fixation was removed in 5 patients, of whom the reconstructed PCL healed well in secondary arthroscopy. [Conclusion] Arthroscopic Posterior Cruciate Ligament reconstruction with the under-the-ACL tibial guide insertion has the advantages with better accurate location，better remnant preservation and better graft translation.