Objective Evaluation of association between pain and functional limitation of osteo-arthritis knee with radiographic features. Methods Total of 123 knee OA patients diagnosed on the basis of American College of Rheumatology Classification (ACR) Criteria for knee OA, attended in Physical Medicine and Rehabilitation (PMR) OPD, JNIMS, were included. Pain and disability were measured using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and radiological grading by Kellgren-Lawrence (KL) grading from x-ray of weight bearing antero-posterior and lateral views. Correlation between WOMAC score and KL grading analysed. Results Sex distribution M:F=9:32, mean age 59.48 (+ 9.8), mean disease duration 4.79 (+ 0.41) months. Correlations of WOMAC pain and KL grading and WOMAC disability and KL grading were insignificant (p > 0.05). Conclusions There is discordance between radiographic findings and clinical features of OA knee and we should not plan treatment on the basis of radiologic grading rather on the functional status and symptoms.