Objective To survey the current status of health literacy and related influencing factors in elderly patients with osteoarthritis. Methods A total of 90 elderly osteoarthritis patients treated in Haikou People′s Hospital from June 2022 to December 2022 were subjected with convenient sampling. Their general data were collected, and the health literacy was investigated and quantized with health literacy questionnaire for chronic disease patients. SPSS statistics 22.0 was used for statistical analysis. Intergroup comparison was performed using students′ t test, analysis of variance or Chi-square test depending on data type. Multivariate linear regression model was used to analyze the influencing factors for health literacy in elderly osteoarthritis patients. Results After 90 questionnaires were distributed, 82 valid questionnaires were recovered. For the 82 participants, the average total score of health literacy scale was (93.0±6.7) points, with the highest average score of dimension of information communication of (4.5±1.1) points and the lowest average score of dimension of information acquisition ability of (3.4±1.2) points. The differences in health literacy scores among patients of different gender, education level, marital status, residence place, per capita monthly families income, and duration of illness were statistically significant (P<0.05). Multivariate linear regression analysis indicated that gender (β=-0.153; P=0.014), marital status (β=-0.179; P=0.006), education level (β=0.438; P<0.001) and disease duration (β=-0.018; P=0.002) were high-risk factors affecting health literacy in elderly patients with osteoarthritis, which could explain 62.1% of the total variables in the equation. Conclusion Elderly patients with osteoarthritis have quite low health literacy. Gender, marital status, education level and disease duration are related factors affecting the health literacy in them.