Patellofemoral instability occurs with the incompatible relationship between patella and femur, which can occur due to many different reasons. There are patients with recurrent complete patellar dislocation, as well as patients with patellofemoral instability who present with only knee pain or a positive apprehension test and no history of dislocation. It is often accompanied by MPFL rupture. Although conservative treatment is often the preferred method after the first dislocation of the patella, the patients who require surgical treatment after the first dislocation are those with osteochondral fragments or significant cartilage damage, as well as those with patella subluxation or patellar dislocation caused by the deterioration of medial stabilizers. In addition to MPFL reconstruction in recurrent patellar dislocation, distal realignment procedures may be added when necessary. Treatment methods are variable and it would be the right approach to apply a treatment option according to the patient.