Background: Osteoarthritis (OA) of knee is an essential public health menace, and a major cause of mobility impairment, mainly among the elderly population. Side-effect free, long-term management of this disease is still not achieved. Methods: This pilot study explores the efficacy of Janu Basti, which is a simple and effective, oleation and sudation procedure of Ayurveda, in the management of this disease. Janu Basti was administered with Ksheerbala oil, followed by local application of medicated steam; total time of therapy was 40-50 minutes per day, and this continued for 21 days. Then there was 5 weeks follow-up, during which the patients had to massage the affected knee daily with Ksheerbala oil, followed by hot fomentation, on their own, at home. Subjective parameters (pain, swelling, stiffness, and crepitus) and objective parameters (WOMAC score, ROM, Walking Time) were analyzed during the study. Results: Six patients completed the study, including treatment of nine knees. Significant improvement was observed in the median values of subjective parameters (pain, swelling, stiffness, and crepitus) and objective parameters (WOMAC score, ROM, Walking Time) analyzed during the study. Patients experienced increasing relief with time, both during initial therapeutic intervention, and follow-up involving self-management at home. Conclusions: The traditional Indian medicine based therapeutic procedure has shown significant promise in the management of OA of knee, both during therapeutic intervention, and follow-up involving self-management at home.