ACL injuries are extremely common1. Lots of clinical tests are decribed in literature for diagnosing anterior knee instability2. Lachmans test, the commonly done clinical test has highest sensitivity among them3. MRI imaging, though expensive, has a sensitivity of 94–98% and is extremely helpful as a non invasive tool4. Our study aims to highlight the simple clinical test described by lelli et all5 , the lever sign test , and compare its sensitivity to other commonly used clinical tests and MR imaging. Clinical sensitivity in Pre–anaesthesia setting for Lever Sign test was 87 %, as compared to Lachman 86 %, Pivot Shift 23 % and Anterior Drawer 67%. After giving anaesthesia, test sensitivity of Lever Sign test was 90 %, Lachman test 93 %, Pivot Shift teat 64 % and Anterior Drawer test 86%. There was no significant association of testing under anaesthesia on sensitivity Lever Signtest ( Mcnemar test p values P=0.344) and Lachman tests (P=0.063). Pivot Shift test(P=<0.001) and Anterior Drawer test(P=0.001) did have significant influence by testing under anaesthesia. Our sensitivity values for Lever Sign is 87 –90%, Lachman is 86–93%, Anterior Drawer is 67–86% and Pivot Shift is 23–64%. We wish to suggest including lever sign test more frequently in clinical scenarios for diagnosing anterior knee instability.