Radiofrequency treatments have become an attractive option for knee osteoarthritis, aiming to disrupt pain signaling by targeting sensory nerves. Across 15 small RCTs, RF—whether conventional, cooled, or pulsed—generally outperformed other non-surgical treatments on short-term pain and WOMAC scores, with the clearest benefits seen at one to six months. Improvements in Oxford Knee Score were less consistent, and 12-month data were sparse. Safety findings were reassuring, with adverse events comparable to injections or analgesics. While cooled and conventional RF often showed stronger effects than pulsed RF, evidence certainty was low due to high heterogeneity and methodological limitations. Larger, well-designed trials comparing RF techniques head-to-head and extending follow-up beyond a year are needed to guide durable clinical decision-making.