Osteoarthritis (OA) is currently the most common type of arthritis, and ultrasound-guided treatment for OA is an important therapeutic approach. Ultrasound-guided intra-articular drug injections and radiofrequency ablation of the affected areas can effectively relieve chronic joint pain in patients with OA. At the same time, targeted therapy for OA using drug-loaded nanoparticles offers unique therapeutic advantages. Among these, biomimetic nanoparticles combine superior targeting capabilities with ultrasonic imaging capabilities, allowing for ultrasonic visualization to monitor the targeting process and the extent of drug release within the biomimetic nanoparticle carriers. This article reviewed conventional treatments for OA—such as ultrasound-guided intra-articular drug injections and radiofrequency ablation—as well as advances in nanotargeted therapy under visual monitoring, covering three types of carriers: metal nanoparticles, polymer nanoparticles, and biomimetic nanoparticles. The aim is to provide additional therapeutic insights for future clinical research on ultrasound-guided nanotargeted therapy for OA and to offer more comprehensive treatment options for clinical practice.