The symptoms in patello-femoral joint can be occurred from various causes. Most of patients complained chronic discomfort and it is rare to have a characteristic acute pain. Initial management should be started conservatively and if it has no effect to relieve symptoms, surgical treatment would be considered. The selection of operative treatment should be decided in the consideration of patients age, activity and ability of performing rehabilitation. Before surgery, accurate diagnosis is essential and causative factors should be removed or corrected with surgery. Arthroscopic surgery is effective for the most of disease in the patello-femoral joint disorder with low morbidity and early rehabilitation. At arthroscopy, superomedial or superolateral portal can be used for the evaluation and treatment of articular surface in the patella. The structure of normal variants should be saved if it does not have pathological changes for prevention of post operative morbidity. If the arthroscopic surgery has difficulties during the procedure or no effect in removal of lesion, open surgery should be considered.