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Abstract Purpose To provide a comprehensive overview of the surgical techniques for medial patellofemoral ligament (MPFL) reconstruction, with a focus on their technical aspects, indications and the advantages and disadvantages of each approach. These techniques vary significantly based on patient‐specific factors, such as skeletal maturity and anatomical complexity. Methods A systematic review of PubMed, Scopus and Embase databases was conducted following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines to identify studies on MPFL reconstruction techniques published within the last 20 years. Studies focusing on technical descriptions of surgical methods were included, while those lacking sufficient detail or reporting only clinical outcomes were excluded. A total of 45 studies met the inclusion criteria and were analysed. Results Autografts, particularly semitendinosus and gracilis tendons, were the most commonly utilized, while allografts and synthetic grafts were less frequently reported. Femoral fixation methods predominantly included interference screws, whereas patellar fixation methods were evenly distributed between bony tunnels and anchors. Dynamic and quasi‐anatomic techniques were commonly employed in patients with open physes to prevent damage to growth plates. Intraoperative fluoroscopy was frequently used to ensure accurate graft placement in anatomical techniques. Open surgical approaches were the most commonly reported, with minimally invasive and arthroscopic methods being less prevalent. Conclusions MPFL reconstruction techniques exhibit considerable variability in graft selection, fixation methods and surgical approaches. Anatomical‐static techniques provide excellent biomechanical stability but may not be suitable for skeletally immature patients. In contrast, quasi‐anatomical and dynamic techniques offer greater flexibility and are particularly advantageous for paediatric populations, though they may compromise long‐term stability. Standardized protocols and further research are needed to optimize outcomes, particularly in complex patient scenarios. Level of Evidence Level III, systematic review.