We evaluated joint line tenderness (JLT) as a test for meniscus pathology in 3531 patients who underwent anterior cruciate ligament (ACL) reconstruction >30 days postinjury. If the patient had no additional giving-way episode after the index ACL injury, the injury was considered subacute; otherwise, it was considered chronic. Immediately before surgery, the presence or absence of medial or lateral JLT was evaluated. During ACL reconstruction, the presence or absence of meniscal tears was documented. In the subacute population, JLT was 41% sensitive, 56% specific, and 50% accurate for detecting medial meniscal tears and 57% sensitive, 44% specific, and 49% accurate for detecting lateral meniscal tears. In the chronic population, JLT was 55% sensitive, 50% specific, and 52% accurate for detecting medial meniscal tears and 46% sensitive, 52% specific, and 50% accurate for detecting lateral meniscal tears. The presence of JLT alone should not be used in the clinical decision making process to guide treatment.