Objective: The aim of this study was to observe the clinical efficacy of Traditional Chinese Medicine (TCM) rehabilitation therapy in senile knee osteoarthritis (KOA). Methods: A total of 80 patients were divided into a control group and an observation group, according to the random digital table method, each group with 40 cases. The control group was given sodium hyaluronate treatment. The observation group was treated with a combination of knee arthralgia external washing prescription and TCM syndrome differentiation acupuncture treatment. Clinical efficacy and Lequesne comprehensive scores, before and after treatment, were compared between the two groups Results: The effective rate in the observation group (95.0%) was significantly higher than in the control group (72.5%, P = 0.006). Lequesne scores in the two groups, after treatment, were lower than before treatment (both P<0.001) but the Lequesne score in the observation group was significantly lower than the control group (P<0.001). Conclusion: TCM rehabilitation therapy, including knee arthralgia external washing and TCM syndrome differentiation acupuncture treatment, is effective in the treatment of KOA, significantly improving clinical efficacy.