Osteoarthritis (OA) involves lesions of the entire joint and remains one of the health problems plaguing the world. The pathological mechanism of OA is complex and involves multiple signaling pathways. Over 300 million people worldwide are living with OA, which imposes a huge burden on society. Nucleic acid nanomaterials are of interest to the biomedical field due to their small dimension, ideal biocompatibility, and structure editability. Various nucleic acids have been used as therapeutic drugs to regulate the pathogenesis and development of OA. Among them, some can enter the cell by themselves and others with the aid of vectors. Apart from high therapeutic efficiency, nucleic acid nanomaterials also act as carriers for transporting drugs. This paper reviews recent advances in nucleic acid nanomaterials in OA therapy, suggesting that nucleic acid nanomaterials-based therapy has good prospects for development.