Osteoarthritis (OA) (degenerative joint disease) is the most common joint disorder. It mostly affects cartilage. The top layer of cartilage breaks down and wears away. Osteoarthritis is of two types, primary (idiopathic) and secondary. In idiopathic osteoarthritis, the most common form of the disease, no predisposing factor is apparent. Secondary OA is pathologically indistinguishable from idiopathic OA but is attributable to an underlying cause. The nonsteroidal anti–inflammatory drugs are the main drugs of choice in modern medicine which have lots of side effects and therefore are not safe for long-term therapy. Raktamokshan, i.e., bloodletting is one of the primeval and important para-surgical procedures defined in Ayurveda for the treatment of numerous diseases. Among them, leech therapy has expanded greater attention worldwide, because of its therapeutic values. The saliva of leech comprises numerous biologically active constituents, which have anti-inflammatory as well as anaesthetic belongings. This case series comprised five cases of knee joint osteoarthritis managed through two sittings of leech application at the interval of 15 days. Complete pain relief with normal range of motion of knee joint noticed after 1 month of treatment.Leech therapy is one of the remedies under investigation, given its claimed analgesic and anti-inflammatory properties.