Elderly with osteoarthritis face considerable physical, social and emotional disabilities. In this chronic disease, there is no cure, improving elderly's' quality of life and reduce joint pain are the best concern. The aim of the study was to evaluate the effect of foot reflexology with pharmacological treatment on pain and quality of life among elderly suffering from osteoarthritis in Tanta city. Study design: Experimental study design was used in this study. Study settings: This study was conducted at outpatient clinic in Physical, Rheumatology and Rehabilitation Department at Tanta University Hospital. Study subjects: A simple randomized sample of 175 elderly with osteoarthritis was included in the study. Study tools: Four tools were used by the researcher. Tool I: Structured Interview Schedule: which composed of three parts. Part I: Socio-demographic characteristics of the elderly. Part II: Medical history of the elderly. Part III: Anthropometric physical parameters. Tool II:  Western Ontario and McMaster (WOMAC) Osteoarthritis Index. Tool III:  Quality of Life Questionnaire.  Tool IV: Knowledge regarding pharmacological treatment of OA. Results:The total mean WOMAC index was significantly reduced. Meanwhile, the total quality of life score increased immediately post and three months after implementation of the intervention (p < 0.005). Elderly knowledge about pharmacological treatment significantly improved immediately post program implementation for both groups(p < 0.005). Conclusion: Foot reflexology appears to have a significantly remarkable effect on pain reduction and improved quality of life. Also, the educational program of pharmacological osteoarthritis treatment was effective and improved elderly's knowledge of both groups Therefore, Foot reflexology technique should be recommended in hospital protocols and gerontological nursing curriculum beside pharmacological treatment of osteoarthritis.