Sialyllactose, known to be abundant in human breast milk, has anti-inflammatory properties, but its preventive effect on osteoarthritis remain unclear. Here, we demonstrated the efficacy of 3' sialyllactose (3' SL) and 6' sialyllactose (6' SL) in preventing osteoarthritis in Yucatan mini-pigs. Twelve female Yucatan mini-pigs were administered 0, 200, 400 mg 3' SL or a combination of 200 mg 3' SL + 200 mg 6' SL for 12 weeks (4weeks before and 8 weeks after surgery); then, osteoarthritis was induced in the left knee by anterior cruciate ligament transection surgery. Kinematic variables were used to quantify gait analysis on the treadmill, and the degree of osteoarthritis was analyzed in the femur and tibia cartilage. It was confirmed that lameness of the left hind limb was reduced in all treated groups compared to the control group. Cartilage disruption was alleviated through macroscopic and microscopic observation of the knee joint. In addition, the expression of pro-inflammatory cytokines (IL-1β, TNF-α) and anti-inflammatory cytokines (IL-10, TGF-β) was decreased in human macrophages (THP-1) by 3' SL. This reduction in cytokine expression was due to the maintenance of M0 macrophages, which did not differentiate into M1 or M2 macrophages. Thus, we suggest that 3' SL and 6' SL have the potential to act as natural therapeutic agents for the prevention of osteoarthritis.