Intra‐articular (IA) injections are used frequently for knee osteoarthritis (OA), but little is known about patients’ attitudes towards these therapies. We aimed to understand better patients’ perceptions of the facilitators of and barriers to IA injections for knee OA. We conducted a qualitative, descriptive/exploratory study and held focus groups and individual interviews with participants with knee OA, including some who had received IA injections and others who had not received IA injections. We held three focus groups with 12 participants and conducted three individual interviews. We identified four themes that shaped participants’ decisions to receive a specific injection:

1) the impact of OA on participants’ lives;

2) participants’ attitudes and concerns, including the desire to avoid surgery, willingness to accept uncertain outcomes, and concerns about side effects and dependence;

3) the way participants gathered and processed information from physicians, peers, and the internet;

4) availability of injectable products.

Participants were concerned about the effectiveness, toxicity, availability, and cost of injectable products. They balanced disparate sources of information, uncertain outcomes, limited product availability, and other injection‐related concerns with a desire to decrease pain. These findings can provide clinicians, investigators, and public health professionals with insights into the challenges patients face when making injection decisions.