Background: Osteoarthritis is a common disease of joint and the knee joint is mostly affected. The prevalence in India is 22-39%. Elder age group are more affected than younger age group. It affects female more than male. Knee OA is strongly associated with occupational activities that involves kneeling and squatting. Fruits, milk, meat, poultry are some protective dietary factors against knee OA. Paucity of community based surveys in Odisha, prompted authors to do a survey to find the prevalence and risk factors of knee OA in the rural community. Materials andMethods: A cross sectional survey was conducted across five villages during September 2017 to February 2018. 299 subjects were selected by multistage sampling. A questionnaire containing sociodemographic profile, diet, ACR criteria and possible risk factors was administered to the subjects after written consent. Then data was analysed using SPSS software version 16.0 Result: Prevalence of knee OA was found to be 29.7% [95% CI: 24.4% -34.8%]. The associated risk factors are age ≥50years [p <0.001], female gender[p=<0.001], BMI more than 27.5 kg/m 2 [p=0.04], lower SES [p=0.03], activity involving kneeling or squatting [p=<0.001] etc. Regular fruit or vegetable consumption provide some protection against knee OA [OR=0.5; 0.3-0.9, p=0.02]. Farming as an occupation was found protective against knee OA [AOR=0.05; 0.009-0.301 P<0.001]. Conclusion: Every third person in this community is having knee OA. Risk factors are advancing age, female gender, and occupational activities involving kneeling and squatting, obesity. Farmers have some protection against knee OA.