The risk of falls among adults with knee osteoarthritis (OA) has been documented, yet, to our knowledge no studies have examined knee OAand the risk of medically treated injurious falls (overall and by sex), which is an outcome of substantial clinical and public health relevance. Using data from the Health Aging and Body Composition Knee Osteoarthritis Substudy, a community‐based study of white and African American older adults, we tested associations between knee OAstatus and the risk of injurious falls among 734 participants with a mean ± SDage of 74.7 ± 2.9 years. Knee radiographic OA(ROA) was defined as having a Kellgren‐Lawrence grade of ≥2 in at least 1 knee. Knee symptomatic ROA(sROA) was defined as having both ROAand pain symptoms in the same knee. Injurious falls were defined using a validated diagnosis code algorithm from linked Medicare fee‐for‐service claims. Cox regression modeling was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs). The mean ± SDfollow‐up time was 6.59 ± 3.12 years. Of the 734 participants, 255 (34.7%) had an incident injurious fall over the entire study period. In the multivariate model, compared with those without ROAor pain, individuals with sROA(HR1.09 [95% CI0.73–1.65]) did not have a significantly increased risk of injurious falls. Compared with men without ROAor pain, men with sROA(HR2.57 [95% CI1.12–5.91]) had a significantly higher risk of injurious falls. No associations were found for women or by injurious fall type. Knee sROAwas independently associated with an increased risk of injurious falls in older men, but not in older women.