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Adverse outcomes in knee osteoarthritis include pain, loss of function, and disability. These outcomes can have devastating effects on the quality of life of those suffering from the disease. Treatments have generally targeted pain, assuming that disability would improve as a direct result of improvements in pain. However, there is evidence to suggest that determinants of pain and disability differ. In general, treatments have been more successful at decreasing pain rather than disability. Many of the factors that lead to disability can be improved with exercise. Exercise, both aerobic and strength training, have been examined as treatments for knee osteoarthritis, with considerable variability in the results. The variability between studies may be due to differences in study design, exercise protocols, and participants in the studies. Although there is variability among studies, it is notable that a majority of the studies had a positive effect on pain and or disability. The mechanism of exercise remains unclear and merits future studies to better define a concise, clear exercise protocol that may have the potential for a public health intervention.