Osteoarthritis (OA) is also called degenerative joint inflammation is the most common joint disease, and its lesions mainly include cartilage degeneration, subchondral bone changes and inflammation of the synovium. At present, the pathogenesis of OA is not clear. Many previous studies have focused on the degeneration of articular cartilage, and recent studies have reported that subchondral bone sclerosis may be a cause of OA, which occurs before the degeneration of articular cartilage. Studying the role of subchondral osteosclerosis in the progression of OA can provide a more comprehensive understanding of the pathogenesis of OA and provide a new perspective for the treatment of OA. This article reviewed recent studies on the role of subchondral bone sclerosis in the pathogenesis of OA to provide help for follow-up basic research and clinical work.