Objective To evaluate the influence of patellar non-resurfacing on the effectiveness after total knee arthroplasty (TKA). Methods Between April 2008 and April 2011, 163 patients with degenerative osteoarthritis of the knee underwent TKA without patellar resurfacing, and the clinical data were retrospectively analyzed. There were 65 males and 98 females, with a mean age of 63 years (range, 54-78 years). According to Outerbridge classification for cartilage degeneration, 22 cases were classified as grade I, 38 cases as grade II, 64 cases as grade III, and 39 cases as grade IV. There was no significant difference in gender, age, and sides among patients at 4 grades (P gt; 0.05). The intraoperative tourniquet-using time and postoperative complications were recorded; the knee society score (KSS), patella score (PS), patients’ satisfaction, and anterior knee pain [using visual analogue scale (VAS)] were used to evaluate the knee function. X-ray films were routinely taken to observe the position of the prosthesis and the patella. Results The mean tourniquet-using time was 125 minutes (range, 90-150 minutes). All incisions obtained healing by first intention, and no early postoperative complication occurred. All patients were followed up 2-5 years (mean, 3.6 years). The KSS and PS scores were significantly improved at 6 months and last follow-up when compared with preoperative scores (P lt; 0.05), but no significant difference between at 6 months and last follow-up (P gt; 0.05). Significant differences in KSS and PS scores were found among patients with different grades of cartilage degeneration at preoperation (P lt; 0.05), but no significant difference at last follow-up (P gt; 0.05). At last follow-up, 7 patients experienced anterior knee pain (mild pain in 5, moderate pain in 2). The results of satisfaction were very satisfied in 90 cases, satisfied in 66 cases, not certain in 5 cases, and not satisfied in 2 cases. No significant difference was found in satisfaction and anterior knee pain among patients with different grades of cartilage degeneration (P gt; 0.05). Conclusion Patellar non-resurfacing has no effect on the effectiveness after TKA.