Abstract. Osteoarthritis is a chronic degenerative joint disorder with the characteristics of articular cartilage destruction, subchondral bone alterations and synovitis. Clinical signs and symptoms of osteoarthritis include pain, stiffness, restricted motion and crepitus. It is the major cause of joint dysfunction in developed nations and has enormous social and economic consequences. Current treatments focus on symptomatic relief, however, they lack efficacy in controlling the progression of this disease, which is a leading cause of disability. Vitamin E is safe to use and may delay the progression of osteoarthritis by acting on several aspects of the disease. In this review, how vitamin E may promote the maintenance of skeletal muscle and the regulation of nucleic acid metabolism to delay osteoarthritis progression is explored. In addition, how vitamin E may maintain the function of sex organs and the stability of mast cells, thus conferring a greater resistance to the underlying disease process is also discussed. Finally, the protective effect of vitamin E on the subchondral vascular system, which decreases the reactive remodeling in osteoarthritis, is reviewed.