Chronic knee pain management with current nonpharmacological or pharmacological measures often has suboptimal results and significant side effects. Sciatic nerve pulsed radiofrequency (SNPRF) is an unexplored alternative for chronic knee pain management. We show a prospective short series of chronic knee pain patients managed with ultrasound-guided SNPRF. Visual analogue scale (VAS) was measured at baseline and 4 weeks after the procedure. The study included 25 elderly patients with severe knee pain. A total of 47 procedures were performed during a 3-month period. VAS scores showed a significant pain difference (p < 0.001) in successive comparison. No patient reported adverse events during the 1-month follow-up period. Ultrasound-guided SNPRF is a new approach for chronic knee pain management that leads to significant pain reduction in the short term. Randomized studies with adequate size, longer follow-up period, and appropriate evaluating tools are warranted to verify these preliminary data.