26 randomized controlled trials (RCTs) analyzing the effects of manufactured Chinese Herbal Formulae (MCHF) for the treatment of osteoarthritis were selected for inclusion. The purpose of this systematic review and meta-analysis was to quantitatively analyze the safety and efficacy of MCHF treatment in knee osteoarthritis in comparison to routine treatments. The results were highly variable; however, MCHF displayed better global pain results in comparison to oral NSAIDs and glucosamine and WOMAC score in comparison to NSAIDs. No significant differences were noted in comparison to oral NSAIDs for pain on walking and sodium hyaluronate was significantly favored in comparison to MCHF in both pain on walking and WOMAC score. Overall, no differences were noted in the Lysholm score and significantly fewer non-serious adverse events were reported with the use of MCHF in comparison to routine therapy.