Wether to resurface or not the patella during total knee arthroplasty (TKA) remains controversial. Actually there is three options: always, never or selective resurface. Surgeons in favour of resurface say that non-resurfaced patients have more anterior knee pain and worst knee function scores. In the other side surgeons that leave patella un-resurfaced advocate that it avoids complications with similar postoperative results. This review will discuss the recent available literature on patellar resurfacing based on randomized controlled trials and published meta-analyses. Most of the meta-analysis seems to favour routinely resurfacing of the patella based on less reoperations. However, the most recent RCT show no difference between both options. So far, a method for accurately predicting which patients can avoid patellar resurfacing has not been found.