Introduction: Knee arthroplasty restores function, improves range of motion and decreases pain & is the treatment of choice for thousands of knee pain sufferers. However, for those who cannot undergo surgery, neurotoxins, which target the pain nerves within the joint, may provide sustained pain relief. The use of intra-articular Botulinum neurotoxin A (BoNT/A) has not been explored for management of pain in osteoarthritis. Materials & Method: Twenty one patients with chronic knee osteoarthritis who had failed treatment with oral and/or intra-articular medications and were not surgical candidates were enrolled in the study.