Patellar dislocation is a relatively common knee injury that affects young adults, more frequently females. It may cause additional cartilage and soft tissue injuries potentially leading to recurrent patellar instability. The stability of the patellofemoral joint is provided by the geometry of the articular surfaces of the patella and femur and by medial and lateral soft tissue restraints. Medial patellofemoral ligament (MPFL) is the main stabilizer. The alteration of local anatomic factors (patellar height, trochlear morphology, tibial tuberosity to trochlear groove [TT–TG] distance, and vastus medialis obliquus anatomy) may contribute to instability. Patellar dislocation often follows a traumatic event causing pain on the medial side of the patella or lateral trochlea, joint effusion, and functional impairment. Recurrence after the first episode is common especially in younger patients. Conservative treatment with initial immobilization and subsequent rehabilitation program are generally indicated, although the risk of recurrence may reach 30%. Surgical approach after the first episode is indicated in case of osteochondral lesions, persistent subluxation, or MPFL avulsion at the femoral insertion where the healing potential is lower. Surgery must always address the lesion of the MPFL through its repair or more often its reconstruction with autografts. The correction of the predisposing anatomic factors to instability is more controversial and is usually performed when they are severely pathological.