Background: Chondromalacia patella (CMP) is a frequent cause of anterior knee pain and may progress to patellofemoral osteoarthritis if undetected. MRI is the imaging modality of choice for non-invasive assessment of patellar cartilage, providing detailed grading and evaluation of associated anatomical risk factors.

Objective: To determine the prevalence and severity of CMP on knee MRI and assess the relationship between cartilage damage and patellofemoral anatomical parameters.

Materials and Methods: A retrospective review was conducted on knee MRI studies performed at a tertiary care center in last 18 months. Patients aged 15 – 75 years with adequate image quality were included; cases with prior patellar surgery or fracture were excluded. Patellar cartilage was graded using the MRI-adapted Outerbridge classification (Grades 0–4). Trochlear dysplasia (Dejour classification), patellar tilt, TT–TG distance, and presence of joint effusion were recorded. Statistical analysis included descriptive statistics, χ² tests for categorical variables, and logistic regression to identify predictors of high-grade CMP (Grade ≥3).