Purpose: Although low-grade inflammatory responses are observed in OA, their contribution to its pathogenesis is unclear. We are investigating the role for the complement system and inflammation in the pathogenesis of OA. Methods: Proteomic studies were performed on OA synovial fluids and membranes. Murine models of OA were used to further investigate the role of the complement system and other inflammatory mediators. Results: Through proteomic analyses of synovial fluids and membranes from individuals with osteoarthritis, we find that expression and activation of complement and other inflammatory mediators in human osteoarthritic joints. Using mice genetically deficient in C5, C6, or CD59a, we show that complement, and specifically the membrane attack complex (MAC)-mediated arm of complement, is critical to the development of OA. Immunofluorescent staining demonstrated that MAC co-localized with matrix metalloprotease (MMP)-13 and with activated extracellular signal-regulated kinase (ERK) around chondrocytes in human osteoarthritic cartilage. Conclusions: Our findings indicate that dysregulation of complement and activation of inflammatory pathways in synovial joints plays a critical role in the pathogenesis of osteoarthritis.