Diagnosis of chondromalacia of the patellofemoral joint using three-dimensional gradient-echo sequences was investigated in 41 patients, with arthroscopic verification in 25 patients. In vitro examinations in human cadaveric patellae were performed in order to determine optimal imaging parameters. FLASH (TR = 40 ms, TE = 10 ms, flip angle = 30 degrees) and FISP (TR = 40 ms, TE = 10 ms, flip angle = 40 degrees) were used in clinical studies. Advanced stages of chrondromalacia could be visualized with high sensitivity. In less advanced disease, overstaging was observed. The therapeutically relevant differentiation of major and minor degrees of chondromalacia seems to be possible. 30 degrees FLASH-images in the axial plane proved to be the most efficacious technique for the diagnosis of chondromalacia.