Medial patella luxation is a common canine orthopaedic problem in toy breeds. A variety of anatomical abnormalities of the pelvic limbs can lead to this developmental problem. Left unmanaged,  the luxation can lead to debilitating osteoarthritis in the patient. Understanding vector forces being exerted on the patella is essential in the surgical management of medial patella luxation.  Each individual patient should be assessed thoroughly to understand the status of the affected leg as a whole to determine appropriate corrective surgical techniques.  The size of the toy breeds presents unique challenges to veterinary surgeons. Useful tips will be shared to avoid complications and achieve a higher success rate in surgical management.