Objective To construct a behavior stratification management system for patients with knee osteoarthritis based on the trans-theoretical model, and to provide an applicable solution for achieving positive and sustainable behavior management in this population. Methods Literature research and Delphi expert consultation were used to construct the behavior stratification management system for patients with knee osteoarthritis based on the trans-theoretical model. Results The effective recovery rates for the two rounds of expert letter questionnaires were 100%.The expert authority coefficients were 0.87 and 0.90; In the second round, the mean values of indicator importance assignment ranged from 4.21 to 5.00, the coefficient of variation ranged from 0.00 to 0.20, and the coordination coefficient ranged from 0.17 to 0.23 (all P＜0.05).The index feasibility assignment mean ranged from 4.04 to 5.00, the coefficient of variation ranged from 0.00 to 0.21, and the coordination coefficient ranged from 0.16 to 0.23 (all P＜0.05).Finally, a behavior stratification management system for patients with knee osteoarthritis was formed, which consisted of 5 first-level indicators, 10 second-level indicators and 34 third-level indicators, including the pre-intention stage, intention stage, preparation stage, action stage and maintenance stage. Conclusion The construction process of the behavior stratification management system for patients with knee osteoarthritis is rigorous and exhibits good reliability.After clinical verification, it can be utilized for managing the behavior of patients with knee osteoarthritis.