This randomized controlled trial aimed to compare the effectiveness of platelet-rich plasma (PRP) injections versus corticosteroid injections in managing knee osteoarthritis (OA). A total of 150 patients with mild to moderate knee OA, confirmed via X-ray, were randomized into two groups: 75 received PRP injections, while 75 received corticosteroid injections. Secondary outcomes included changes in pain levels using the Visual Analog Scale (VAS), improvements in the Knee Injury and Osteoarthritis Outcome Score (KOOS), and evaluation of adverse effects. Results demonstrated a significantly greater improvement in WOMAC scores for the PRP group (12.8 ± 3.1) compared to the corticosteroid group (6.2 ± 2.8, p < 0.001). Similarly, VAS pain reduction and KOOS functional scores were significantly better in the PRP group. No serious adverse effects were reported in either group. PRP’s superior efficacy is likely due to its regenerative properties, which promote cartilage repair and reduce inflammation over the long term, whereas corticosteroids provide only short-term relief. The findings align with existing literature suggesting PRP’s longer-lasting benefits in knee OA treatment. However, limitations include the relatively short follow-up period and variations in PRP preparation. Future research should focus on optimizing PRP protocols, assessing long-term effects, and exploring cost-effectiveness. These results support PRP as a more effective and safer alternative to corticosteroids for intra articular therapy in knee OA.