Osteoarthritis (OA) is a degenerative disease that causes irreversible and progressive destruction of articular cartilage. However, there is no effective method to delay the progression of OA. In recent years, more and more evidences show that the occurrence and development of OA is correlated with the increase of senescent cells in joint tissue, and senescent cells and their senescent associated secretory phenotype (SASP) have been implicated in cartilage degeneration and OA. Targeted clearance of senescent cells can prevent articular cartilage degeneration and OA progression. In view of the important role of cell senescence in OA, this paper reviews the progress of the causal relationship between cell senescence and OA, the potential cellular and molecular mechanisms of cell senescence leading to the occurrence and development of OA, as well as targeted removal of senescent cells in OA therapy.