Knee osteoarthritis is the most frequent type of arthritis and is a main reason of disability. Its occurrence in India is 22% to 39%. In Contemporary medicine, OA is usually treated with Acetaminophen, aspirin and non-steroidal antiinflammatory drugs (NSAIDs) as pain relief medicines. Extreme exploit of NSAIDs can escort to gastric complications. Total knee Arthroplasty (TKA) is extensively employed in the management for end-stage osteoarthritis but Pneumonia is one of the most frequent complications after knee Arthroplasty. It is the main reason of readmission and death subsequent to surgery. In Ayurveda, Osteoarthritis can be linked with sandhigata vata because of its similarity in clinical features. This is a case of knee Osteoarthritis who was suggested Arthroplasty. She was effectively treated with internal medication & some external therapy. Osteoarthritis is usually managed by Ayurveda practitioners but from this case study, it can be concluded that severe osteoarthritis may be managed by Ayurvedic intercession.