Medial patellar subluxation is a poorly recognized clinical condition characterized by chronic anterior knee pain that is exacerbated with knee flexion. Additional symptoms include instability, limited knee motion, and pain with squatting and stair climbing. Full characterization of the patient's knee pain requires an accurate history and physical examination. Diagnosis is typically confirmed during diagnostic arthroscopy. When nonsurgical management (eg, physical rehabilitation, patella-stabilizing bracing) fails, surgery (eg, medial retinacular release, lateral retinacular imbrication, newer techniques to repair or reconstruct the lateral retinaculum/lateral patellofemoral ligament) can lead to good results. Further study is needed to confirm current understanding of medial patellar subluxation and to better define treatment options and prevention strategies.