Cranial cruciate ligament (CrCL) rupture and associated pathology is a common cause of lameness in dogs. This condition is often called “cruciate disease” (CrCLD). Medial patellar luxation (MPL) is also a common cause of lameness in dogs, particularly in small breed dogs. These two common conditions can be present concomitantly in one stifle. Clinical signs of lameness due to these two conditions are complex. Studies have shown the association between CrCLD and MPL; however exact mechanism remains to be elucidated. In this lecture, surgical options to treat these two closely associated conditions will be discussed.