The NACHT, LRR, and PYD domains-containing protein 3 (NLRP3) inflammasome is involved in the pathogenesis of arthritis. Knee osteoarthritis (KOA) is considered to be an inflammatory disease. Increasing attention has been paid to the correlation between the NLRP3 inflammasome and KOA. The assembly and activation of the NLRP3 inflammasome produces a large number of pro-inflammatory factors and degradative enzymes, leading to cartilage destruction, synovial inflammation and pain onset. This review will summarize the evidence related to the involvement of the NLRP3 inflammasome pathway in KOA and its role in the pathology of osteoarthritis, with the aim of enhancing the management of KOA and providing new directions for the diagnosis and prevention of KOA.