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Purpose: This level IV study describes a new 1-stage procedure for revision ACL reconstruction in cases with extreme tunnel widening. Methods: Eight consecutively treated subjects requiring ACL revision and presenting with excessive tunnel widening (87,5% to 250% tunnel enlargement) were included in this study. The graft-tunnel mismatch was resolved in this 1-stage revision procedure by the use of custom-made 8 to 10mm cylindrical shaped bone allografts in a press-fit construct with the ACL-graft in combination with the usual fixation devices for ACL-reconstruction. All subjects were evaluated pre-operatively and at a minimum follow-up of 1 year by the IKDC objective and subjective scores, KOOS, and Tegner activity scale. Results: Mean improvement was 24,8 ± 16,1 on the KOOS evaluation (P-value 0,006) and 38,1 ± 16,8 on the IKDC subjective score (P-value 0,001). The objective IKDC scores improved significantly with an average of 1 grade (P-value 0,038). Anterior laxity as determined on the KT-1000 arthrometer improved with an average of 3.63mm compared to the situation before primary reconstruction, and the Pivot-shift test was negative in all but one patient after the revision procedure while positive in all patients before primary reconstruction. Conclusion: This new surgical technique using 8-10 mm allograft bone cylinders for the management of excessive tunnel enlargement at single stage revision ACL reconstruction delivers excellent results after minimum 1 year of follow-up. The results of this study have the potential to lower the threshold for 1-stage surgery in ACL revision complicated by extreme tunnel widening.