Background: This study was performed with the aim to explore the expression of high-mobility group protein B1 (HMGB1) and the receptor for advanced glycation end-product (RAGE) in knee osteoarthritis (KOA) and its clinical significance. Material/Methods: A total of 108 synovial tissues selected from KOA patients were included in the experimental group. Seventy-five synovial tissues of knee joints, selected from patients who were clinically and pathologically confirmed without joint lesion, were included in the control group. The mRNA and protein expressions of HMGB1 and RAGE were determined by using RT-PCR and immunohistochemistry, respectively. Western blotting was used for measuring relative protein expression. An ROC curve was drawn to evaluate the diagnostic value of HMGB1 and RAGE for KOA. Results: The positive cell number and positive expression intensity of HMGB1 and RAGE in synovial tissue was higher in the experimental group than in the control group. PI for HMGB1 and RAGE expression in KOA patients was positively correlated with clinical classification of X-ray films (P<0.05). HMGB1 and RAGE mRNA expressions, as well as relative protein expression of HMGB1 and RAGE in synovial tissue, were higher in the experimental group than in the control group (all P<0.05). The sensitivity of HMGB1 protein, RAGE protein, HMGB1 mRNA, and RAGE mRNA were 76.9%, 64.8%, 86.1%, and 64.8%, respectively; and the specificity was 100%, 96%, 74.7%, and 80%, respectively. Conclusions: The protein and mRNA expressions of HMGB1 and RAGE are both increased in KOA patients, suggesting that they are involved in KOA.