Abstract Background: Diabetes mellitus (DM) and osteoarthritis (OA) are commonly increased in prevalence and commonly oc-cur together, both of them are leading causes of disability. The relationship between Diabetes mellitus (DM) and osteoarthritis (OA) is not known, consequently, the purpose of this study to identify if there is an association between them. Aim of Study: To investigate the association between dia-betes mellitus and knee osteoarthritis and the effect of diabetic type or diabetic duration on the progression of knee osteoarthri-tis through a systematic review. Material and Methods: Systematic searches were done on the following electronic databases MEDLINE / PubMed, Cochrane Library ,Web search, SAGE, Google scholar, Scop-us, since the inception of these databases From February 2022- February 2023. Results: Fifty studies were included in the current review, 32 studies of them were included to identify the association between diabetes and knee OA, Ten studies were used to cal-culate the risk of knee osteoarthritis in diabetic patients, among 4148 patients, the overall OR was 1.24 (CI 1.14 to 1.35). Seven studies were used for the risk of DM in an OA versus non-OA subjects, among 2468 patients, the overall OR was 2.26 (1.28 to 4.01). The mean OA prevalence among diabetic patients was 34.29%, while DM prevalence among OA patients was 23.45%. Conclusion: Diabetes mellitus is strongly associated with knee OA, and each of them is a major cause of others as seen by higher OA prevalence in diabetic patients and vice versa.