The purposes of this prospective cohort study were (1) to assess if second anteriorcruciate ligament (ACL) injury rate 2 years after ACL reconstruction (ACLR) in those whoreturned to pivoting sport was associated with meeting (a) quantitative return to sport(RTS) criteria, (b) qualitative RTS criteria, and (c) combined quantitative and qualitativeRTS criteria, and (2) to determine why athletes did not return to their preinjury (level of)sport. Athletes after ACLR performed RTS tests immediately before RTS:​ sevenmovement quantity (strength and hop test battery) and two movement quality (coun-termovement jump with LESS score and hop‐and‐hold test) tests. A 2‐year post-operative questionnaire asked for RTS, reasons for not returning to the same (level of)sport and second ACL injuries. One hundred and forty‐four athletes (82%)completed the questionnaire and 97 of them returned to a pivoting sport. Seven ofthese athletes had a second ACL injury. Meeting the hop test battery RTS criterion(absolute risk reduction 11%;​p= .047) and hop‐and‐hold test RTS criterion (absoluterisk reduction 15%;​p= .031) were both significantly associated with a reduced secondACL injury rate. Meeting combined RTS criteria were not significantly associated withsecond ACL injury rate. Therefore, RTS tests after ACLR should at least comprise a hoptest battery or the hop‐and‐hold test to reduce second ACL injury risk after return topivoting sport. Also, one‐third of all athletes mentioned fear of reinjury as the mainreason for not returning to their preinjury (level of) sport. This psychological componentshould be taken seriously and discussed during rehabilitation.