The internal architecture of the human patella was studied by quantitative stereological analysis of microradiographs made from sagittal and horizontal sections. The predominant structural (trabecular) element was found to be oriented sheets of hard tissue connected laterally by rods of the same material. The sheets change orientation in a correlated and systematic manner which appears to be in response to the biomechanical demands made on the patella. The predominant variable in the determination of density (and, presumably, other physical properties) was the intertrabecular spacing rather than trabecular thickness. It was found that the sheet-and-rod model could be used to calculate all of the structural parameters in a consistent manner.