Background Anterior Cruciate Ligament injury is a serious injury, which mainly occurs in pivoting sports and the risk is higher in women. Purpose The purpose of this study was to evaluate to what extent women return to their previous sports activity after an ACL reconstruction. Another purpose was to characterize those who successfully return and those who do not. Materials and Methods Sixty-four women, who had undergone ACL surgery using a hamstring graft, were evaluated three to six months after surgery with a battery of strength tests and self-assessment scales. The women answered, on average 26 months after surgery, a web-based questionnaire with questions about if and to what extent they had succeeded in returning to their previous physical activity. Results Thirty women (47%) reported that they had returned to their previous physical activity level. They also increased their level of activity after returning. Those women who returned had a higher hamstrings limb symmetry index (LSI), a higher goal for their future physical activity, a higher current physical activity level and scored higher on all five dimensions of the Knee Osteoarthritis Outcome Score (KOOS). Conclusions Women who successfully returned to their pre-injury sports activity, had, in the early postoperative tests a higher physical activity, a higher goal for their future physical activity, lower pain and symptoms, better knee function, a higher knee related quality of life and a higher LSI compared with those women that did not return. Level of evidence II, prognostic study.