Background: ACL avulsion fractures are more common in children. They occur due to low velocity road traffic accidents or due to sports injury in which hyperextension of knee joint occurs. Undisplaced fractures are treated conservatively with excellent outcomes, however displaced fractures need to be managed operatively to produce better outcomes. The aim of this study is to assess the clinical and radiological outcomes of arthroscopic reduction and fixation of tibial spine avulsion in patients with closed physis with ACL suture pull out technique. ACL suture pullout technique is a relatively new operative modality for management of ACL avulsion fractures. Method: 45 patients having displaced ACL Avulsion fractures were treated with ACL suture pullout technique and were followed up for 1 year. Lysholm knee score and International Knee Documentation Committee (IKDC) score was used for evaluation. Result: Out of 45 patients, 41 patients had Lachman test negative at final followup while 4 patients had mild laxity with otherwise satisfactory functional outcome. 2 patients had restricted flexion which was managed surgically. No infection or deep vein thrombosis was seen. Conclusion: Based on this study, we can say the arthroscopic suture pull out technique is better than other management as the technique has better clinical outcomes and have very less complication.