Objectives: To determine eccentric knee flexor strength in elite female Australian Rules Football (ARF) players with and without a history of unilateral anterior cruciate ligament reconstruction (ACLR) using an ipsilateral semitendinosus graft.

Design: Case-control.

Setting: Elite ARF Women's competition.

Participants: Eighty-four elite female ARF players (mean age, 25 ± 4.9 years; height, 1.71 ± 0.73 m; weight, 67 kg ± 7.4 kg) with (n = 12) and without (n = 72) a history of unilateral ACLR in the previous 10 years.

Main outcome measures: Peak eccentric knee flexor force during the Nordic hamstring exercise (NHE).

Results: Players with a history of unilateral ACLR displayed lower levels of eccentric knee flexor strength in their surgically reconstructed limb than their uninjured contralateral limb (mean difference −53.77 N, 95% CI = −85.06 to −24.27, d = −0.51) and compared to the limbs of players with no history of injury (mean difference = −46.32 N, 95% CI = −86.65 to −11.13, d = −0.73).

Conclusion: Elite female ARF players with a history of unilateral ACLR display deficits in eccentric knee flexor strength in their surgically reconstructed limb for up to 10 years following surgery.