Abstract Background: Osteoarthritis is a common disease in Egypt; with a prevalence of 8.5%. This disease is more common in females than males and predominantly affects the knees. Retro walking is a novel treatment method for knee osteoarthritis. Aim of Study: The study was conducted to investigate the effect of 4 weeks of retro-walking exercise on pain in patients with knee osteoarthritis. Patients and Methods: This study was carried out on for-ty-two patients of both genders with mild to moderate knee os-teoarthritis. Their ages ranged from 40 to 55 years, and their body mass index (BMI) didn't exceed 30kg/m2. All patients were referred by the orthopedic surgeon who diagnosed knee osteoarthritis based on clinical and radiological examination. Patients were divided randomly into two groups: Group A the control group and group B the retro-walking group. The con-trol group received four weeks of conventional exercises three times per week. The walking group received four weeks of retro walking exercise 3 times per week from 10min up to 30 minutes added to conventional exercise, the intensity of Pain measured by the Visual Analogue Scale (VAS). Results: The results of this study revealed that all patients showed a statistically (p-value <0.001) significant decrease in pain in VAS score in favor of retro-walking group. Conclusion: Retro-walking is an effective method to re-lieve pain in patients with mild to moderate knee osteoarthritis.