Sixty-four patients with chronic knee osteoarthritis were randomized to receive genicular nerve phenol neurolysis (n=32) or radiofrequency ablation (RFA) (n=32). The primary outcome of interest was treatment response as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes included Numeric Rating Scale (NRS) scores, adverse effects, and rate of meaningful pain relief (>50% reduction in pain). Outcomes were assessed at 1 week, 1 month, and 3 months. Overall, the results of the study revealed that both treatments significantly improved WOMAC and NRS scores from baseline at all time points with no significant differences between groups. However, paresthesia was more common in the phenol group. These findings suggest that phenol neurolysis is a viable, lower-cost alternative to RFA for managing chronic KOA pain.