With the aging population trend, knee osteoarthritis (KOA) has gradually become one of the leading causes of disability and deformity among middle-aged and elderly people in China. As a key component of the stepped care approach for KOA, intra-articular injection (IA) plays a critical role in alleviating mild KOA and delaying the need for surgical intervention. However, despite advancements in intra-articular injection techniques and understanding, there remain numerous controversies regarding its clinical application both domestically and internationally. How to provide precise, standardized, and effective intra-articular injection therapy for KOA patients is an urgent clinical issue to address. In light of this, the expert panel of this consensus referred to international standards, the latest research evidence, guidelines, and consensus documents from China and abroad, integrating opinions from multidisciplinary experts to develop this consensus. The consensus aims to guide clinicians in the safe and standardized use of intra-articular injections, thereby improving the diagnosis and treatment level of intra-articular injection therapy within KOA stepped care. The consensus puts forward 10 recommendations, covering aspects such as the target population for KOA intra-articular injection therapy, treatment goals, selection of injectable drugs, medication strategies, and the exploration and application of new intra-articular injection biological agents. The consensus emphasizes that intra-articular injection therapy for KOA patients should be based on comprehensive individual assessment and implemented properly according to actual clinical circumstances.