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A fair and adaptive call admission control algorithm for multimedia low Earth orbit (LEO) satellite networks was proposed. Based on current call dropping probability of destination cell, this algorithm reserves bandwidth for handoff calls using double threshold method. To avoid the discrimination of quality of service (QoS) caused by the allocation based on fair bandwidth, this algorithm adopts the bandwidth allocation rule based on fair QoS. Simulation results show that the proposed algorithm can accurately and adaptively reserve bandwidth, present satisfactory call blocking probability and greatly reduce handoff call dropping probability, while guarantees the high bandwidth utilization.