Objective To observe the clinical effect of extracorporeal shock wave combined with Tibetan medicine Nengxiu therapy on knee osteoarthritis. Methods Sixty patients with knee osteoarthritis in a department of Tibetan Hospital of Haibei Tibetan Autonomous Prefecture in Qinghai province were randomly divided into control group and treatment group (30 cases in each group).Both groups received routine treatment, including acupuncture, salt compress and foot bath, once a day, 7 days a week for 3 weeks.Control group received conventional treatment and Nengxiu therapy, treatment group plus extracorporeal shock wave therapy on the basis of the control group. Knee function and inflammatory factors were assessed 3 weeks later. Results After 3 weeks, knee function and inflammatory factors in both groups were improved compared with those before treatment (P＜0.05). After treatment, pain, joint stiffness, daily life score, total scores, serum CRP, IL-1β and TNF-α in the treatment group were significantly lower than those in the control group (P＜0 05). Conclusion Extracorporeal shock wave combined with Tibetan medicine Nengxiu therapy can improve knee function and reduce knee inflammation in patients with knee osteoarthritis, and its effect is better than nengxiu therapy alone