20 studies were included in this meta-analysis comparing total knee arthroplasty with or without patellar resurfacing. The primary outcome of interest was the knee component of the Knee Society Score (KSS). Secondary outcomes of interest included the functional component of the KSS, re-operation rate (any reason, due to anterior knee pain, due to patellofemoral complications, due to non-patellofemoral complications), anterior knee pain, patient satisfaction, the Oxford Knee Score (OKS), the Knee Injury and Osteoarthritis Index Score (KOOS) and range of motion. Results revealed significant differences in the knee and functional KSS components, risk of re-operation for any reason and risk of re-operation due to anterior knee pain in favour of the patellar resurfacing group. All remaining pooled outcomes were not significantly different between the two groups.