Anterior knee pain is a very common complaint among active individuals and is sometimes resistant to nonoperative management. When operative treatment is indicated to relieve anterior knee pain, a careful evaluation of alignment, flexibility, and the degree of patellofemoral arthrosis is necessary to choose the correct operative procedure. Lateral release is often successful in relieving symptoms of anterior knee pain but is not the answer for all patients and should not be used as a first-step operation when arthrosis and malalignment are severe. The techniques used to perform lateral release are relatively simple but are not without important pitfalls. Attention to detail in diagnosis, surgical treatment, and postoperative rehabilitation is important for successful outcome.