Patellofemoral problems including patellofemoral dysplasia, overuse injuries, plica syndrome and osteochondritis may be seen in childhood and adolescence. Lateral patellar compression syndrome is characterized by developmentally activity-related knee pain without patellar instability. The only factor, which distinguishes chronic patellar incomplete dislocation (subluxation) from lateral patellar compression syndrome, is patellar subluxation with or without patellar tilt in axial X-ray. Periodical sense of giving way, locking, and catching and recurrent effusions of the knee are the major manifestations of recurrent patellar dislocation. Patellar dislocation is the most critical one among them. Early treatment of patellofemoral dysplasia is of utmost importance to prevent arthrosis development. Overuse injuries caused by several risk factors are particularly seen during the growing spurts of adolescents. Osgood- Schlatter disease and Sinding-Larsen-Johansson syndrome are the most common pathologies among them. Patella-trochlear osteochondritis is a condition resulting from recurrent overload on the joint, usually presenting with patellar subluxation. Once osteonecrosis develops, subchondral fracture leads to osteochondral detachment with a joint mouse (loose body), pain and mechanical symptoms. Physiologically impaired septum to regress may result in synovial plicae of the knee and particularly suprapatellar septa. This condition does not always lead to a symptomatic disease in the patient.