Anterior knee pain (AKP) is one of the most frequent reasons for adolescents and young adults to seek consultation for knee conditions. Owing to the complex multifactorial aetiology of AKP, with local, proximal and distal factors potentially involved, its treatment is particularly difficult and challenging for the practitioner. A careful history and physical examination are crucial for an accurate diagnosis and therefore a correct treatment. The entire lower extremity should be examined, with findings complemented by imaging studies to arrive at a diagnosis. Arriving at a precise diagnosis is the cornerstone of developing an appropriate treatment. Given that the aetiology of AKP is multifactorial, individualised treatment must be tailored to the patient. Early intervention is very important to maximise the chance of a good prognosis. Non-surgical management is effective in the majority of patients. Surgery is indicated solely in cases with pain that is refractory to non-operative treatment and well-defined structural abnormalities that are deemed to be the cause of the AKP can be targeted for repair or correction.