One hundred twenty patients with knee osteoarthritis and metabolic dysfunction-associated steatotic liver disease were randomized to receive either blood flow restriction (BFR) training (n=60) or traditional weight-bearing (WB) training (n=60). The primary outcome of interest was pain reduction using the Knee Injury and Osteoarthritis Outcome Score (KOOS). Secondary outcomes included range of motion (ROM), scaled maximal isotonic strength (10RM), self-reported function (KOOS), and performance in the 30-second chair sit-to-stand test. Outcomes were assessed at 1, 4, and 12 weeks. Overall, the results of the study revealed that BFR training significantly improved pain, muscle strength, and physical function compared to WB training alone at 12 weeks. These findings suggest that BFR training is a more effective rehabilitation method for KOA patients with MASLD.