Osteoarthritis (OA) is one of the most prevalent conditions resulting to disability particularly in elderly population About 13% of women and 10% of men aged 60 years and older have symptomatic knee OA. The proportions of people affected with symptomatic knee OA is likely to increase due to the aging of the population and the rate of obesity or overweight in the general population. There are multiple factors associated with this progressive disease such as obesity, female gender, and repetitive trauma. Pain is the most common symptom in knee OA, a leading cause of chronic disability, clinical diagnosis will be supported by certain radiological findings. There are numerous conservative therapies that help to relive symptoms depend on severity of Osteoarthritis, and knee replacement remains standard of care in advance disease. Fat Micrografting is evolving technique with promising result in selected patients with regenerative and reparative effect of adipocyte-derived stem cell toward damaged cartilage and bone, which supported by clinical evidence.