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Low fall efficacy can lead to activity restriction and loss of independence, which may cause severe adverse consequences. The purpose of this study was to explore fall efficacy among elders with knee osteoarthritis and influential factors in three communities in Beijing, China. A correlational descriptive study design was used with a sample of 117 participants from July 2014 to November 2014. Results showed that participants had low fall efficacy and that fall efficacy correlated with age, gender, body mass index, marital status, education, disease duration, frequency of falls, number of co-morbidities, pain, stiffness, physical function, depression, lower-extremity muscle strength and balance ( r = −0.594 to 0.234, P < 0.05 to 0.001). Multiple regression analysis revealed that 52% of variance in fall efficacy was explained by fall frequency, age, body mass index, gender, pain and balance function. Findings suggest that strategies to prevent falls, reduce body weight, improve effective pain management and enhance balance function may improve fall efficacy in this population. [ABSTRACT FROM AUTHOR]