Mortality has not been a major area of investigation in osteoarthritis. The author conducted a systematic review and identified seven studies that provided data on either mortality or survival in persons with osteoarthritis; an additional two articles with relevant data were identified through review of reference lists. Studies included persons with radiographic evidence of osteoarthritis as well as clinical samples of patients with osteoarthritis. Results were pooled using the method of best evidence synthesis. Overall, there was moderate evidence of increased mortality among persons with osteoarthritis compared with the general population. Increased cause-specific mortality was observed in some studies from cardiovascular and gastrointestinal disorders. Risk factors for mortality in persons with osteoarthritis included an increased burden of osteoarthritis, advanced age, and presence of comorbid conditions. Possible explanations for the excess mortality include reduced levels of physical activity among persons with osteoarthritis due to involvement of lower limb joints and presence of comorbid conditions, as well as adverse effects of medications used to treat symptomatic osteoarthritis, particularly non-steroidal anti-inflammatory drugs.