This study employed descriptive qualitative research methods to explore the experiences of patients with knee osteoarthritis.Semi-structured interviews were conducted with 20 patients diagnosed with knee osteoarthritis and scheduled for joint replacement at a tertiary hospital in Shanghai between January 2024 and June 2024. Thematic content analysis was utilised to analyse the interview data.The findings were categorised into four main themes and 10 sub-themes: (1) Experience of illness and treatment; (2) The effect of symptoms on the patient; (3) Experience of Negative Emotions; (4) Need for External Support. This study offers an in-depth examination of the experiences and needs of individuals with knee osteoarthritis concerning disease management and treatment.Through interviews, we identified multilevel challenges faced by patients in terms of their illness experiences, treatment decisions, lifestyle modifications, and emotional responses. These findings will serve as a valuable reference for developing interventions aimed at improving treatment outcomes and enhancing the quality of life for patients.© 2025 John Wiley & Sons Ltd.