Background: Osteoarthritis is the fourth leading cause of years lived with disability around the world. Prevalence of osteoarthritis is more in females compared to males. Objective of the study is to find out the prevalence of osteoarthritis of knee in middle aged women and factors associated with it. Methods: A cross -sectional study was conducted in ward 16 of Ettumanoor panchayat. A total of 375 women above 40 years were included in the study. The data was collected at their residences using a semi structured interview schedule which include demographic details and various factors associated with osteoarthritis. Weight, height, waist circumference were measured and knee joint examination was done. Data analyzed by SPSS version 19.0.The factors that were found to have a statistical significant relationship with osteoarthritis were analyzed using logistic regression. Results: The prevalence of knee osteoarthritis in the study sample was 41.6% (95% CI- 41.6±1.25%). Among them 66.2% have bilateral osteoarthritis of knee joint. The factors that had a significant association with osteoarthritis were increasing age (p value of 0.001(OR=2.47(1.61-3.79), attained menopause or not (p value of 0.001(OR=3.15(1.96-5.06), underwent hysterectomy or not (p value of 0.038) (OR=2(1.02-4.04), family history of osteoarthritis (p value of 0.035 (OR=1.61(1.04-2.61), BMI>30 ( p value of 0.027(OR=1.86 (1.03-3.33), and history of trauma to the knee joint (p value of 0.042 (OR=1.51(0.88-2.59). Conclusions: The prevalence of knee osteoarthritis in the study was 41.6% and the factors associated with knee osteoarthritis as per the study were increasing age, attainment of menopause, hysterectomy, family history of osteoarthritis, BMI>30 and history of trauma to the knee joint.