Background <p>Data on the clinical outcomes of combined medial patellofemoral ligament (MPFL) and medial quadriceps tendon femoral ligament (MQTFL) reconstruction for patellar instability remain scarce.</p> Methods <p>A systematic literature search was conducted in Web of Science, Embase, and PubMed on June 9, 2025. All studies reporting clinical outcomes after combined MPFL/MQTFL reconstruction for patellar instability were included. Methodological quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS). General characteristics, surgical technique, clinical outcomes, satisfaction, and complications were recorded.</p> Results <p>Five studies comprising 180 patients (188 knees) were included. The mean age was 14.8 years (range 12–22 years), and the mean follow-up was 34.6 months (range 24–49 months). Children and adolescents accounted for 67.8% of the cohort (<i>n</i> = 122). The mean Insall-Salvati ratio (ISR) or Caton-Deschamps index (CDI) was 1.2, and the mean tibial tubercle-trochlear groove (TT-TG) distance was 16.6&#xa0;mm. Trochlear dysplasia was present in 86.2% of knees (162/180). Allografts were the most commonly used grafts (<i>n</i> = 103, 54.8%). Methods of quadriceps tendon fixation included soft tissue tunnel fixation (<i>n</i> = 61, 37.2%), and soft tissue suture fixation (<i>n</i> = 103, 62.8%). The overall complication rate was 8.0% (15/188), with recurrent dislocation occurring in 2.1%. No patellar fractures or growth distrubances were reported.</p> Conclusions <p>Combined MPFL and MQTFL reconstruction is a safe and effective technique for treating patellar instability in both pediatric and adult patients, demonstrating low rates of recurrent dislocation and complications. However, the optimal surgical technique remains controversial.</p>