Abstract Background: This is a prospective comparative study to evaluate the functional outcomes in Patellar Resurfacing Compared with non Resurfacing in Total Knee Arthroplasty. Aim of Study: The aim of this study was to compare clinical and radiographic outcomes of TKA with and without patellar resurfacing using a patella-friendly prosthetic design This study was focused on clinical outcomes and complications related to the patellofemoral joint. Two groups in the first half of the study, the patella was resurfaced in all patients, while it was retained in all patients in the second half of the study. The selection nature was not based on age, comorbidities, patella morphology, obesity, or pre-operative radiographs. Patients and Methods: In the period between December 2015 and September 2017, a prospective RCT was conducted involving 40 patients having knee osteoarthritis (20 cases had Resurfacing Patella 20 cases had non Resurfacing Patella). Results: We identified 40 eligible TKRs, including 20 RP. Compared to 20 No R P. The knee society scoring system used for pre- and post-operative assessment. The mean pre-operative knee score in R P knee was 39 and the mean pre-operative functional score was 56.25 while in No RP knee group the mean pre-operative knee score was 38 and the mean pre-operative functional score was 55.75. In R P knee group the mean post-operative knee score was 94.70 which is con-sidered excellent result. And the mean post-operative functional score was 76 which are considered good result while in No RP knee group the mean post-operative knee society score was 98.90 which is considered excellent result and the post-operative functional score was 74.75 which also considered good results. Conclusion: We founded that there wasno significant difference between both groups with post-operative improve-ment in all cases.