Objective To evaluate the clinical effects of behavioral stratification management in patients with knee osteoarthritis based on trans-theoretical model.Methods A total of 142 patients with knee osteoarthritis were enrolled by convenience sampling method and divided into a control group and an intervention group by random number table method, with 71 cases in each group.The control group received routine nursing intervention, and the intervention group received behavioral stratification management based on cross-theoretical model for knee osteoarthritis patients.Behavioral change stage, arthritis self-efficacy and osteoarthritis index were evaluated before the intervention and at 4, 12 and 24 weeks of the intervention.Results A total of 66 cases in the intervention group and 63 cases in the control group completed the study.After 12 weeks of intervention, there was statistical significance in the distribution of behavioral changes between the two groups (P＜0.05).After 4 weeks of intervention, there were statistically significant differences in arthritis self-efficacy and osteoarthritis index scores between the two groups (all P＜0.05), and the time effect, intervention effect and interaction effect were significant (all P＜0.05).Conclusion Behavioral stratification management based on trans-theoretical model can promote the change of behavior stage, enhance self-efficacy and improve joint function in patients with knee osteoarthritis.