The relationship between structural foot deformities and excessive subtalar joint pronation as being contributory to patellofemoral pain has not been well documented. It was the purpose of this study to assess the rearfoot posture in patients diagnosed with patellofemoral pain compared with a normal population. In addition, the intratester reliability in obtaining rearfoot measurements was assessed for right and left sides in 21 normal subjects. A goniometer was used to measure rearfoot posture in 30 female subjects (15 with patellofemoral pain and 15 controls). Measurements were taken with the subjects prone and the subtalar joint in neutral. Intraclass correlation coefficients were good for both the right and left measurements (.87 and .86, respectively). A small but significant increase in rearfoot varus was found in the patellofemoral pain group compared with the control group (8.9 vs. 6.8 degrees; p = .0002). These results suggest that increased rearfoot varus may be a contributing factor in patellofemoral pain and should be assessed when evaluating the events at the subtalar joint and the lower extremity. In addition, it has been demonstrated that consistent rearfoot measurements can be obtained by an individual clinician.