Background: The degree of patient’ s suffering in association with radiological evidence of osteoarthritis (OA) determines the timepoint of surgery. Thus, amoreclear understanding of the association between Clinical and radiological symptoms of OAis necessary. Objectives: Here we aim to evaluate how Clinical and radiographic symptoms of patients are associated with each other in an IranianKnee OA population. Methods: In a cross-sectional study, patients with knee OA were recruited. The diagnosis of OA was made using the criteria ofAmerican College of Rheumatology (ACR) Classification. Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC)was used as an indicator of self-reported disability. The Kellgren-Lawrence index was used for OA grading. Results: A total of 96 OA patients, including 77 females and 19 males, with a mean age of 53. 27 10 years, were included. The OA wasgraded as I, II, III, and IV in 28, 35, 19, and 14 patients, respectively. The mean WOMAC score was 55. 2 20. 5, ranging from 6. 3 to 100. TheWOMACscore was not significantly correlated with the grade of OA (p = 0. 1, r =-0. 188). When we stratified the patients based ontheir gender, a strong correlation was observed between WOMAC scores and OA grade in male patients (p < 0. 001, r =-0. 882), whileit was still non-significant in female patients (p = 0. 9, r = 0. 002). Conclusions: Self-reported disability is associated with radiographic symptoms in male patients with knee OA, but not in females. Hence, the orthopedic surgeons should consider this discrepancy in their decision-making process to decide appropriately aboutthe choice of therapy.