Unilateral patellar tendon ruptures are a common complication that can occur frequently among athletic patients below the age of 40; however, bilateral spontaneous patellar tendon ruptures are rare and still not fully understood. We present a case of bilateral patellar tendon rupture in a 37‑year‑old patient with a history of systemic lupus erythematosus (SLE) who had concomitant chronic renal failure. Primary repair utilizing the Krackow interlocking stitch technique provided excellent outcomes in both knees. This case highlights the rare occurrence of spontaneous bilateral patellar tendon rupture in patients with SLE and chronic renal failure.