PURPOSE: This study aimed to clarify lower limb alignment characteristics and the relationship between coronal and sagittal lower limb alignment in Japanese patients with knee complaints but without knee osteoarthritis (KOA). METHODS: This retrospective study included 200 knees from Japanese patients with knee complaints but without KOA aged 60 years and under presenting with knee complaints between May 2020 and May 2023. We assessed coronal parameters, including mechanical hip knee angle (mHKA), arithmetic HKA (aHKA) mechanical lateral distal femoral angle and medial proximal tibial angle (MPTA), and sagittal parameters, such as medial posterior tibial slope (MPTS) and lateral posterior tibial slope (LPTS). In addition, we compared differences between CPAK types. RESULTS: A weak positive correlation was found between mHKA and MPTS, but not with aHKA. Moderate negative and moderate positive correlations were found between mHKA and MPTA and between medial and LPTS, respectively. CONCLUSIONS: Little correlation was found between the coronal and sagittal parameters in patients with knee complaints but without KOA. LEVEL OF EVIDENCE: Level Ⅲ.