A systematic literature search for evidences comparing treatment effect and harm of resurfacing versus nonresurfacing the patella in total knee arthroplasty was conducted and yielded five meta-analysis (MA), one systematic review (SR) and six randomized controlled trials not included in previous MAs/SR. The evidence suggests that patellar resurfacing would reduce the risk of anterior knee pain, as well as the risk of patella-related reoperation. Furthermore, patients not undergoing patella resurfacing would experience more knee pain during stair climbing and be less satisfied with surgery. No significant difference in range of motion can be expected with or without patellar resurfacing. Importantly, methodological limitations were observed in all retrieved studies and evidences about potential adverse events related to patellar resurfacing are presently undetermined.