Background and Aim: Total knee arthroplasty (TKA) surgeries are growing annually. Reporting the early patellar related complications in patients undergoing TKA was the aim of this study. Patients and Methods: In this prospective study, medical history, clinical and radiological evaluation, and planning and simulation were performed preoperatively. The Knee Society Score was used to assess the clinical outcomes. Early patellar related complications were assessed. Results: This study included thirty patients with a mean age of 60.73±6.84 years and most of them were ladies (76.7%) with male to female ratio was 1: 3.29. A significant improvement in the mean Functional Score section of Knee Society Score, from 62.6±2.35 preoperatively to 90.0±0 postoperatively, with a mean follow-up period of six months. Additionally, a significant improvement in flexion deformity was detected. (10%) of cases showed anterior knee pain due to patella-femoral origin, patellar clunk was seen in (3.33%), patella alta in (10%), and none of them reported rotational malalignment, infection, venous thromboembolism (VTE), or stiffness.  Conclusions: TKA with medial parapatellar approach achieves excellent clinical and radiological outcomes with a low incidence of early patellar related complications such as persistent pain and patella alta or clunk