Patellofemoral joint (PFJ) should be examined in all three planes; it is a complex anatomical structure regulated by the interplay of bony structure, soft tissue constraints and muscle activities. As the alignment of the patella is affected by the alignment of the lower extremities, the load distribution on the patellofemoral joint also correlates with the alignment in all three planes. For the patellofemoral joint, for which many parameters have historically been suggested on the static evaluation, dynamic and weight-bearing evaluations are currently prominent. In addition, the wide variations in alignment-related parameters between healthy and sick individuals are attributed not only to individual anatomical variations, but also to the low standardization of imaging methods. Meanwhile, the effects of current concepts such as dynamic valgus and soft tissue alignment on PFE are also discussed.