Purpose <p>This article aims to review the progress of minimally invasive tension band techniques in the treatment of patellar fractures, summarize the operational points, clinical outcomes, and advantages and disadvantages of various techniques, and provide a reference for clinicians.</p> Methods <p>A literature search was conducted in PubMed, Cochrane Library, and China National Knowledge Infrastructure databases up to December 2023. Search terms included “patella fracture” or “patellar fracture” combined with “minimally invasive,” “percutaneous,” “tension band,” or “arthroscopic.” Clinical studies on minimally invasive tension band treatment for patellar fractures were included.</p> Results <p>Minimally invasive tension band techniques mainly include simple tension band technique, K-wire tension band technique, cannulated screw tension band technique, and non-absorbable suture technique. Based on the use of arthroscopic assistance, they can be categorized into arthroscopically assisted and non-arthroscopically assisted minimally invasive techniques. Compared with traditional open surgery, minimally invasive tension band techniques have significant advantages in operative time, hospital stay, postoperative pain, joint function recovery, and cosmesis. However, issues such as the need for secondary implant removal surgery and the controversial necessity of arthroscopic assistance remain unresolved.</p> Conclusion <p>Minimally invasive tension band techniques for patellar fractures may offer potential advantages including reduced soft tissue trauma, earlier postoperative mobilization, and improved cosmetic outcomes. However, the current evidence base is limited by a predominance of small, retrospective studies with heterogeneous techniques and short-term follow-up. While these approaches represent a promising direction, high-quality comparative studies with long-term outcomes are needed to establish definitive superiority over conventional open techniques.</p>