[Objective] To compare the clinical effect of multi-ligament reconstruction and repair with or without tourniquet for KD-Ⅲ-M knee dislocation. [Methods] A total of 27 patients with knee joint dislocation combined with multiple-ligament injuries admittedfrom January 2017 to January 2022 were randomly divided into two groups using a random number table. In the tourniquet group, 13 pa-tients received multi-ligament reconstruction and repair underwent tourniquet, while in the non-tourniquet group, 14 cases were operatedon without tourniquet. The perioperative data and follow-up results were compared between the two groups. [Results] All patients in bothgroups were operated successfully without significant differences in terms of operation time, intraoperative blood loss, ambulation time aftersurgery, postoperative hospitalization days between the two groups (P＜0.05). However, the non-tourniquet group had significantly lowerpostoperative drainage volume than the tourniquet group [(35.6±2.7) ml vs (72.2±3.3) ml, P＜0001]. The VAS scores significantly decrease,whereas the Lysholm and IKDC scores significantly increased in both groups over time postoperatively (P＜0.05). The non-tourniquet groupproved significantly superior to the tourniquet group in VAS score 1week after surgery [(4.4±0.8) vs (5.6±0.9), P=0.021], despite of the factthat it became not significant between the two groups latterly (P＞0.05). There were no statistically significant differences in Lysholm and IK-DC scores between the two groups at any corresponding time points (P＞0.05). [Conclusion] The multi-ligament reconstruction and repairfor KD-Ⅲ-M dislocation of the knee achieve satisfactory clinical consequences, while the non-tourniquet operation has the advantages ofless drainage and less early pain.