Chondromalacia patella is a condition characterized with anterior knee pain and softening, fissuring or ulceration in the posterior aspect of patellar cartilage. Approximately half of the healthy individuals at the age of >20 years and almost every individual at the age of >50 years, softening in the patellar cartilage is present. This condition which can be observed during arthroscopic procedure for other reasons has no clinical relevance, unless it is painful. It presents with softening and swelling of the cartilage initially, while fissuring and appearance of subchondral bone may be seen at the advanced stage. Conservative treatment should be always the first treatment of choice. In refractory patients, arthroscopically shaving of the loose chondral fragments may relieve the symptoms partially. If there is a patellar malalignment, lateral retinacular release, proximal or distal realignment procedures and finally elevation of tibial tubercle should be also considered. Although autologous chondrocyte transplantation is a relatively novel method, the outcomes of the procedure in combination with realignment procedure are better.