OBJECTIVE: We hypothesized that individuals with a normal foot posture would be less likely to experience patellar tendon pain and pathology than those with a pronated or supinated foot. DESIGN: Observational study. SETTING: Field-based study among competing athletes. PARTICIPANTS: Volleyball players competing in the Victorian State League, Australia. ASSESSMENT OF RISK FACTORS: Patellar tendinopathy (PT) is common in sports involving running and jumping and can severely limit athletes' ability to compete. Several studies have investigated potential etiological factors for the development of PT, but little is known about the association between PT and foot posture. MAIN OUTCOME MEASURES: Static foot posture index (FPI), patellar tendon pain during single-leg decline squatting, and gray scale ultrasound imaging were measured in 78 recreational to elite volleyball players (48 men and 30 women). RESULTS: Men with patellar tendon pain were more likely to have a normal foot posture and men without pain were more likely to be pronated according to the FPI (P < 0.05). Women showed no association between FPI and pain or imaging (P > 0.05). CONCLUSIONS: Men with a normal foot posture were more likely to have PT compared to men with a pronated foot type.