Osteoarthritis (OA) is a degenerative joint disease and a leading cause of adult disability. While joint replacement surgery is a common treatment option for end-stage disease, non-surgical management is critical for preventing disability and maintaining quality of life. Although therapeutic ultrasound, which applies mechanical and may also apply thermal energy in the form of sound waves, is widely used to treat various musculoskeletal disorders such as bone fractures, tendinopathy, and muscle contusions, its symptom- and disease-modifying effects on osteoarthritis have not been clearly demonstrated. Recent clinical evidence indicates therapeutic ultrasound is capable of relieving OAassociated pain and improving function of diseased joints. Furthermore, in vitro and in vivo studies are beginning to emerge which suggest ultrasound may exert chondroprotection, such as enhancing anabolic activity, suppressing proteolytic enzyme-mediated degradation of the cartilage matrix, preventing chondrocyte apoptosis and modifying the endocrinology of adipose tissue that may potentially contribute to OA disease initiation and progression. Therefore, ultrasound may have great potential to serve as an effective and non-invasive therapeutic treatment for osteoarthritis.