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Introduction: Knee osteoarthritis (OA) is one of the commonest problems in general population that is more likely to increase in future as the population ages. Aquatic exercises are advanced non-invasive techniques used in the management of knee OA. This research aims to provide evidence regarding effects of aquatic exercises and its general feasibility in reducing pain, improve body function and quality of life (QOL). Material & Methods: A systematic review was conducted following PRISMA guidelines. Literature search was done using PubMed and PEDro database. Randomized Controlled Trials using different mesh terms related to knee OA and aquatic intervention were included. The main outcome parameters were pain, range of motion, power and QOL. Results: We identified a total of 32 studies for this systematic review. After screening, 15 articles were included. All studies showed that aquatic exercises may decrease pain and increase ROM. The result suggests that aquatic exercises are effective in decreasing pain and increasing ROM, muscles power and QOL. Conclusion: Aquatic exercises are effective for the patients with knee OA. Aquatic exercises decrease knee joint pain, reduce joint stiffness and enhance walking speed, range of motion, muscle power and QOL.