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Background At present, the most effective and mature treatment after ACL injury and tear is ACL reconstruction, but the rehabilitation process after ACL reconstruction that is very long, so it is very important to find early MRI positive findings of knee instability. Methods We retrospectively collected the clinical and imaging data of 70 patients who underwent ACL reconstruction from January 2016 to December 2019; Based on clinical criteria, the patients were divided into a stable group (n = 57) and an unstable group (n = 13); We measured the MRI imaging evaluation indexes, including the position of the bone tunnel, graft status, and the anatomical factors; Statistical methods were used to compare the differences of imaging evaluation indexes between the two groups; The prediction equation was constructed and ROC curve was used to compare the prediction efficiency of independent prediction factors and prediction equation. Results There were significant differences in the abnormal position of tibial tunnel entrance, percentage of the position of tibial tunnel entrance, position of tibial tunnel exit, lateral tibial posterior slope (LTPS), width of intercondylar notch between stable knee joint group and unstable knee joint group after ACL reconstruction (P P Conclusions We found that abnormalities of the position of the exit of the bone tunnel, lateral tibial posterior slope (LTPS) and sagittal obliquity of the graft were the early MRI positive findings of knee instability after ACL reconstruction. It is helpful for clinicians to predict the stability of knee joint after ACL reconstruction.