The present retrospective study evaluates the clinical, arthroscopic, and follow-up findings in 37 patients with patellofemoral pain syndrome suspected to be a result of patellar tracking abnormality without patellar instability. The results indicate that arthroscopic evaluation of patellofemoral motion is an accurate way to define patellar malalignment. Arthroscopic lateral release gave satisfactory results in 39 of 43 knees. Unsatisfactory results were associated with chondromalacia, prolonged effusion, or painful crepitation.