Patellar instability, which includes subluxation and dislocation, is a common problem that frequently impacts young, energetic individuals, resulting in considerable morbidity and diminished knee function. This condition stems from abnormal patellofemoral biomechanics, resulting in recurrent pain and instability episodes. Patellar dislocations can be categorized into habitual, recurrent, persistent, obligatory, and acute types, each with distinct clinical presentations and underlying etiologies. Key factors contributing to patellar instability include bony abnormalities such as patellar dysplasia, patella alta, and trochlear dysplasia, as well as soft tissue imbalances involving the lateral parapatellar retinaculum, vastus lateralis, and iliotibial band. Medial soft tissue deficiencies, generalized ligamentous laxity, and increased Q angles further exacerbate the condition. Clinical examination is critical and involves assessing pain, gait abnormalities, quadriceps wasting, and patellar tracking. Special tests, including the apprehension test and patellar tilt test, aid in diagnosis. Imaging modalities like X-ray, MRI, CT scans, and ultrasound provide valuable insights into the structural and functional status of the patellofemoral joint.