Background: Non-invasive treatment options are preferred for managing upper extremity pain due to osteoarthritis (OA). Transcutaneous pulsed radiofrequency (TcPRF) is a promising technique and appears effective in managing knee and shoulder pain. Objectives: To investigate whether TcPRF treatment is effective in reducing pain and safe to use among patients with OA of the upper extremity. Methods: In this retrospective study, patients with painful OA of the upper extremity who underwent TcPRF treatment from February 2021 to February 2022 were included. The primary outcome measure was the change in NRS pain scores between baseline and 1, 2, and 6 weeks of follow-up. Secondary outcome measures included adverse events. Data were extracted from electronic medical records and via telephone consultation after the 6-week follow-up. Results: A total of 41 initial TcPRF treatments were performed among 37 patients. The NRS score at rest showed a statistically significant improvement at 6 weeks [median = 5 [interquartile range (IQR) 2 - 8)] compared with baseline [median = 6 (IQR 4 - 8)], P = 0.023, with a moderate effect size, r = -0.44. For NRS scores during activity, all follow-up moments had lower NRS scores [median = 7 (IQR 5 - 8)] than before TcPRF [median = 8 (IQR 7 - 9)], P = 0.002 - 0.006, with moderate to large effect sizes, r = -0.45 to r = -0.51. No adverse events were reported. Conclusions: Transcutaneous pulsed radiofrequency treatment is effective in reducing pain and is safe to use among patients with upper extremity pain due to OA.