Knee osteoarthritis affects hundreds of millions worldwide, and with rising prevalence, interest in nonoperative options like platelet-rich plasma (PRP) has surged. Although early pre-clinical work suggested regenerative potential, clinical evidence has remained inconsistent, often limited by variable preparation methods, heterogeneous protocols, and poor reporting. Despite this, PRP use and related research continue to expand, driven by patient demand and commercial growth. Meta-analytic data show PRP can modestly improve pain and function compared with saline, hyaluronic acid, and corticosteroids, without increasing adverse events. Still, wide variability and low certainty across studies limit strong clinical endorsement. More rigorous, transparent trials are essential to define which PRP formulations, dosing strategies, and patient groups truly benefit, and to clarify its role in managing knee osteoarthritis.