Background: Patients with knee osteoarthritis who experience depression might have worse health outcomes. The aim of the present study was to explore the occurrence of depression and the factors influencing depression in community-dwelling elderly patients with osteoarthritis of the knee in China. Methods: We conducted a cross-sectional, correlational descriptive study. The study included 214 participants aged 60 and older diagnosed with knee osteoarthritis.Results: The mean total score of depression was 4.43, and depression correlated with age, body mass index (BMI), education, frequency of falls, number of comorbidities, use of walking aids, taking pain relief or cartilage protectors, pain, stiffness, physical function, social support, mobility function and the muscle strength of lower extremities (r = -0.342 to 0.525). Analysis using hierarchical multiple regression demonstrated that falling frequency, using walking aids, the number of comorbidities, BMI, physical function, social support, and stair-climb test explained 40.8% of the variance in depression.Conclusions: The present study demonstrated that depression among elderly people with knee OA is a serious problem. Strategies to increase patients’ physical function, prevent falls, lose weight, treat comorbid conditions, and encourage them to increase positive social interaction, and engage in muscle strength training might relieve depression in these patients.