Knee osteoarthritis (OA) is a common disease, particularly among the elderly, that can cause functional disability due to impaired joint function and pain. Recent studies have shown that extracorporeal shockwave therapy (ESWT) can accelerate the healing of meniscal degeneration and plays a chondroprotective role in OA. However, there can be doubts as to whether ESWT’s effect on knee osteoarthritis is strong enough to offset disease progression, given the difficulty of ESWT in penetrating deep tissues in the human body, the impossibility of exposing the entire knee cartilage and subchondral bone to ESWT, and the nature of the progressive knee OA. In this paper, the author will review the literature published so far to introduce the effective ness of ESWT in the treatment of knee OA and help readers gain an objective perspective.