Abstract: Objective To observe the efficacy of needle warming moxibustion combined with massage manipulation on cold-dampness type of knee osteoarthritis. Methods Two hundred and twenty patients with cold-dampness type of knee osteoarthritis admitted to Tongxiang Hospital of Traditional Chinese Medicine and the First Hospital of Jiaxing from January 2017 to December 2018 were divided into observation group and control group by the random number table method, with 110 cases in each group. Both groups were treated with needle warming moxibustion, and observation group was additionally treated with massage manipulation. Both groups were treated for 2 courses. The clinical efficacy, pain degree, knee function and quality of life evaluated with health survey scale MOS SF-36 were compared between the two groups, and the incidence rate of adverse reactions was recorded. Results The clinical cure rate of observation group was significantly higher than that of control group(34.55% vs. 20.00%, χ²=5.866, P=0.015). After treatment, the scores of pain rating index(PRI), visual analogue scale(VAS) and present pain intensity(PPI) of both groups were decreased, and the scores of observation group were lower than those of control group(t=-6.912,-10.364,-8.975, all P<0.001). The scores of different dimensions and total score of knee function, scores of different dimensions and total score of quality of life of both groups were increased after treatment. Besides, the scores of different dimensions and total score of knee function(t=5.465, 5.059, 3.863, 6.014, 13.852, all P<0.001), scores of different dimensions of quality of life(t=8.777, 9.877, 2.963, 5.553, 5.799, 2.127, 5.714, 4.403, all P<0.05) in observation group were higher than those in control group. Conclusion Compared with simple needle warming moxibustion for cold-dampness type of knee osteoarthritis, combined application of massage manipulation can further optimize clinical efficacy, relieve pain, and improve knee function and quality of life, with safety.