Abstract： Objective： To observe the effect of warm- needling moxibustion combined with hot compress with Chinese medicine on levels of hypoxia- inducible factor- 1(HIF- 1α) and fibroblast growth factor- 2(FGF- 2) in patients with knee osteoarthritis. Methods： A total of 70 cases of patients with knee osteoarthritis were selected and divided into the control group and the observation group according to the random number table method， with 35 cases in each group. The control group was treated with hot compress with Chinese medicine， and the observation group was treated with warm- needling moxibustion combined with hot compress with Chinese medicine. The clinical effects in the two groups were observed. Changes in the scores of Chinese medicine syndromes， Visual Analogue Scale(VAS) for pain and Lysholm Knee Score Scale(LKSS)， as well as the levels of tumor necrosis factor- α(TNF- α)， matrix metalloprotein 1(MMP- 1)， interleukin- 6(IL- 6)， bone γ- carboxyglutamate- protein(BGP)， bone alkaline phosphatase(BALP)，tartrate-resistant acid phosphatase 5b(TRACP 5b)，HIF-1α and FGF-2 were compared between the two groups. Results： After treatment， scores of joint pain， joint swelling， morning stiffness，vexing heat and sweating easily，and pulse manifestation and tongue coating in the two groups were decreased when compared with those before treatment， and the above five scores in the observation group were lower than those in the control group，differences being significant(P＜0.05). After treatment， VAS scores in the two group were decreased when compared with those before treatment， and LKSS scores were increased(P＜0.05)；VAS score in the observation group was lower than that in the control group，and LKSS score was higher，differences being significant(P＜0.05). After treatment，levels of TNF- α， MMP- 1 and IL- 6 in the two groups were decreased when compared with those before treatment(P＜0.05)， and the above three levels in the observation group were lower than those in the control group(P＜0.05). After treatment， levels of BGP and BALP in the two group were increased when compared with those before treatment， and TRACP- 5b levels were decreased(P＜0.05)； levels of BGP and BALP in the observation group were higher than those in the control group，and TRACP-5b level was lower， differences being significant(P＜0.05). After treatment， levels of HIF- 1α in the two group were decreased when compared with those before treatment，and FGF-2 levels were increased(P＜0.05)；level of HIF-1α in the observation group was lower than that in the control group，and FGF-2 level was higher (P＜0.05). After treatment，the total effective rate of clinical effects was 91.43% in the observation group and 68.57% in the control group， the difference being significant(P＜0.05). Conclusion： Warm- needling moxibustion combined with hot compress with Chinese medicine has a good curative effect in treating knee osteoarthritis. It can effectively relieve inflammatory responses，improve bone metabolism and knee joint function，and reduce levels of HIF-1α and FGF-2.