The decision to resurface or leave the patella unresurfaced during total knee arthroplasty (TKA) has been a controversial issue. Ten trials (1,003 knees) were identified in this meta-analysis to examine the advantages and disadvantages of patellar resurfacing during TKA for patients with osteoarthritis (OA). The available evidence demonstrated that patellar resurfacing reduced the risk of reoperation following TKA; however, the absolute risk difference for reoperation was low. Moreover, no difference in anterior knee pain was observed with patellar resurfacing. This meta-analysis was unable to conclude whether patellar resurfacing is recommended during TKA.