Patellar subluxation with osteochondral fracture due to acute trauma is uncommon in emergency medicine. Patients with peripatellar pain frequently have underlying patellofemoral malalignment. However, early diagnosis may be difficult because of the lack of association between the pathological changes that produce the consequence of the tracking abnormalities and traditional radiographic views. The diagnosis of patellofemoral malalignment and chondral damage is usually established through clinical findings. The condition should be suspected when there is hemarthrosis following trauma, and particularly where the patient describes any sort of disorientation or malalignment in the knee.Herein, we elucidate the clinical aspects of patellar subluxation with osteochondral fracture and review the relevant literature.