Background: Osteoarthritis (OA), also known as degenerative joint disease, primary OA, wear and tear arthritis, or age-related arthritis, is a leading cause of disability worldwide. Although the disease pathophysiology is still poorly understood and is under investigation, it is accepted that it is multifactorial in origin with genetic, biological, and biomechanical components. Aetiological factors are also joint specific. Aim of work: To assess level of Anxiety and Depression Scale (HADS) in its Arabic version among the studied patients and use this important tool in evaluation of psychological status of the studied group. Patient and Methods: This study was conducted on 73 knee osteoarthritis (KOA) patients attended to the inpatient ward and outpatient clinics of Rheumatology and Rehabilitation Department, Zagazig University hospitals. The sample size was calculated using open epi according to the following total number of OA patients coming to ZUH in 3 months expected to be 100 case and ppv of questionnaire was 76% (ref) so at CI 95% the sample size was calculated to be 73 cases. All patients were subjected to general, systemic, local examination, and laboratory investigations. We used (HADS) in its Arabic version for assessment of level of anxiety and depression among the osteoarthritis patients depending on its cut of values. Results: Mean depression score was 7.93, about 27% of patients had abnormal score. Mean anxiety score was 8.8. about 34% of patients had abnormal score. There is significant positive correlation between depression score and duration of morning stiffness, inactivity, WOMAC score and anxiety score. There is significant positive correlation between anxiety score and disease duration, WOMAC score and depression score. There is significant negative correlation between anxiety score and age. Conclusion: Anxiety and depression prevail among patients with knee osteoarthritis. Higher scores of anxiety and depression are associated with impaired function of knee osteoarthritic patients. Physicians are highly recommended to consider these comorbidities in patients with OA to improve patient outcomes.