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The current study investigated whether osteoarthritis pain was associated with physical function and aimed to identify possible multistep indirect pathways of the association between pain and physical function through sleep quality, depression, and fatigue. Using the survey method, data were collected from 222 adults age ≥65 years diagnosed with osteoarthritis at a senior welfare center in Daejeon, Korea. Data were statistically analyzed using serial multiple mediation analysis. Study findings showed that the relationship between pain and limitation of physical function was partially mediated by sleep quality, depression, and fatigue. The experience of pain among older adults with osteoarthritis directly and most strongly led to limitations in physical functioning, and pain-induced sleep disorders, depression, and fatigue may sequentially negatively affect physical functioning. Thus, pain is a possible fundamental cause of poor, or deterioration in, physical functioning in older adults with osteoarthritis. Therefore, pain assessment and pain management should be prioritized when caring for older adults with osteoarthritis. [Journal of Gerontological Nursing, 45(7), 46–54.], Osteoarthritis is the most common musculoskeletal disorder as well as a leading cause of chronic pain and functional limitation (Altman, 2010), affecting approximately 30.8 million adults in the Unites States [...]