Analysis of data on 4,796 participants from the Osteoarthritis Initiative has revealed an increased risk in all-cause mortality in individuals with knee osteoarthritis (OA). Compared with individuals with no knee pain and no radiographic knee OA, individuals with symptomatic knee OA (pain and radiographic progression) had a hazard ratio (HR) for mortality of 2.2 (95% CI 1.6–3.1), whereas those with radiographic OA had an HR of 2.0 (95% CI 1.4–2.9), and those with knee pain only had an HR of 0.9 (95% CI 0.6–1.4). Disability and changes in quality of life related to OA partly contributed to the increase in mortality.