[Objective] To compare the clinical efficacy of two remnant preserved posterior cruciate ligament (PCL) reconstruction. [Methods] A retrospective study was conducted on 50 patients who received remnant preserved PCL reconstruction for PCL tear in our hos- pital from March 2012 to March 2020. According to the preoperative doctor-patient communication, 28 patients had the tibial tunnel locat- ed through the path under the axillary part of the anterior cruciate ligament (ACL) (subaxillary group) , while the other 22 patients were posi- tioned through the upper ACL and PCL gap path (conventional group). The perioperative period, follow- up and imaging data were com- pared between the two groups. [Results] All the patients in both groups got operation performed successfully, without complications such as injuries to vascular vessel and nerve during operation. The subaxillary group proved significantly less intraoperative blood loss than that in the conventional group (P＜0.05) . All patients were followed up for more than 2 years, and there was no significant difference in the time to return to full weight-bearing activity between the two groups (P＞0.05) . The Lysholm score, IKDC score, and knee flexion-extension range of motion (ROM) increased significantly (P＜0.05) , while VAS pain score and extent of posterior drawer test were significantly reduced in both groups over time (P＜0.05) . The subaxillary group proved significantly superior to the conventional group in terms of VAS pain score, Lysholm score, IKDC score, and posterior drawer test at 6 months and last follow-up (P＜0.05) . In terms of imaging, the subaxillary group got significantly better coronal position ratio (a/b) of the tibial tunnel intraarticular aperture than the conventional group (P＜0.05) , despite the fact that there was no significant difference in sagittal position ratio (c/d) between the two groups (P＞0.05) . The posterior tibial displace- ment in stress X-ray at 90° of knee flexion significantly reduced postoperatively in both group compared with that preoperatively (P＜0.05) , which in the subaxillary group was significantly less than the conventional group at 6 months and latest follow-up (P＜0.05) . [Conclusion] This arthroscopic remnant preserved PCL reconstruction by ACL subaxillary positioning of tibial tunnel is more conducive to accurate posi- tioning of the internal aperture of tibial bone tunnel, and does more effectively preserve the PCL remnant, and achieve better clinical outcome.