Introduction: Anatomic variation of distal femur or tibia may have been described in literature, but there are few studies to describe components asymmetry in sequential bilateral total knee arthroplasty. We did retrospective analysis of incidence of femoral, tibial and patellar component asymmetry in sequential bilateral total knee arthroplasty. Materials and methods: We selected 134 patients for retrospective analysis of femoral, tibial and patellar component asymmetry in sequential bilateral total knee arthroplasty, assuming hypothesis that component sizes in bilateral knee arthroplasty may or may not be same. Results: We found asymmetry rate of 19.4% in femur components, 21.17% in patellar components and 14.17% in tibial components, which is higher than other studies. However, when pre– and postoperative knee society scores were compared between the symmetric and asymmetric cases the difference was found to be insignificant. Conclusion: We conclude that there is significant percentage of both femoral, tibial and patellar component asymmetry and each knee should sized independently while doing sequential bilateral total knee arthroplasty.