Background: Anterior cruciate ligament (ACL) injuries are frequently associated with concomitant medial collateral ligament (MCL) injuries, which compromise knee stability and increase graft stress after isolated ACL reconstruction. This combined injury pattern is particularly prevalent in contact sports and high-energy trauma, necessitating a comprehensive approach to surgical management to ensure optimal patient outcomes. While open medial collateral ligament reconstructions are time-consuming and associated with significant morbidity, arthroscopic MCL augmentation using Fiber Tape offers a minimally invasive and rapid technique to address this complex injury. This approach aims to restore knee function, reduce the incidence of osteoarthritis, and is crucial for successful tendon-bone healing following ACL reconstruction (Tian et al., 2023). Methods: A prospective study of 25 patients (ages 18–40 years) with combined ACL and high-grade MCL injuries was conducted between 2022 and 2024. All patients underwent single-stage arthroscopic ACL reconstruction with hamstring autograft and MCL augmentation using Fiber Tape. Clinical outcomes were assessed with Lysholm Knee Score, IKDC score, and valgus stress radiographs preoperatively and at 3, 6, and 12 months postoperatively. Results: The mean operative time for combined procedure was 82 minutes (range: 70–95). Valgus stability was restored in all patients by 3 months. At 12 months, the mean Lysholm score improved from 46.2 ± 7.1 to 91.5 ± 4.6, and IKDC score improved from 42.8 ± 6.5 to 89.2 ± 5.1 (p < 0.001). None of the patients had residual valgus laxity or graft failure. Two patients developed transient stiffness, which resolved with physiotherapy. Conclusion: Arthroscopic MCL augmentation with Fiber Tape, performed simultaneously with ACL reconstruction, is a safe, quick, and effective technique for restoring medial stability. It reduces graft stress, avoids prolonged rehabilitation, and ensures excellent short-term outcomes with minimal complications.