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Background. Knee osteoarthritis is a prevalent degenerative joint disease associated with pain, functional limitation, and reduced quality of life. Krill oil, a marine-derived source of omega-3 fatty acids with antioxidant properties, has been explored as a potential adjunctive intervention. This systematic review and meta-analysis evaluated the efficacy and safety of krill oil supplementation in knee osteoarthritis. Methods. A systematic review and meta-analysis of randomized controlled trials was conducted using multiple electronic databases. Adults with clinically or radiographically diagnosed knee osteoarthritis were included. Outcomes included knee pain, physical function, stiffness, biomarkers, and adverse events. Meta-analyses were performed using a random-effects model. Results. Three randomized controlled trials involving 597 participants were included. Krill oil supplementation showed numerical improvements and favorable trends in WOMAC-assessed pain, stiffness, and physical function, but these effects did not consistently reach statistical significance. No significant differences were observed for Visual Analog Scale–assessed pain or systemic biomarkers. Adverse event rates were comparable between groups and were predominantly mild gastrointestinal symptoms. Conclusion. Krill oil has been investigated as a potential adjunctive approach for knee osteoarthritis, with limited evidence suggesting possible short-term benefits in patient-reported outcomes.