Complications related to the patellofemoral joint seen after total knee arthroplasty are not as popular as some other complications in regard to frequency and majority such as infection or instability. As the patellofemoral joint is somehow neglected by surgeons on various grounds during primary total knee arthroplasty, its problems are also often underestimated. The spectrum of these complications has a wide range: from anterior knee pain –which is considered to be multifactorial but most commonly associated with patellofemoral joint– to patellar fracture and dislocation. It should be noted that patellofemoral joint-induced problems encountered after total knee arthroplasty are not only caused by surgical operations on patella and patellar components, but also by applications on other bones and procedures related to the tibio-femoral joint. While these problems were encountered more frequently in early design total knee arthroplasties, they decreased in proportion to the developments in prosthesis design and surgical technique. However, even nowadays, patellofemoral joint originated problems can be sometimes difficult to solve, may require severe attempts of revision, and also significantly affect the quality of total knee arthroplasties` results.