INTRODUCTION: Autologous chondrocyte implantation (ACI) is an effective treatment for chondral defects of the knee; however, its use in kissing lesions is less well documented. CASE REPORT: A 23-year-old female with a kissing lesion of the patellofemoral compartment on magnetic resonance imaging underwent two-stage ACI to her medial patella (20 mm x 22 mm) and medial trochlea (27 mm x 18 mm). At 1-year follow-up, the patient had returned to all activities with near-complete resolution of symptoms and substantial improvement in clinical outcome scores. CONCLUSION: Patients with kissing lesions of the knee can be treated successfully with ACI performed to multiple sites.