Osteoarthritis (OA) is the most common rheumatic degenerative condition affecting joints, involving a gradual erosion and loss of articular (joint) cartilage, inflammation, and structural alterations of the joint. It causes pain associated with movement, stiffness, reduced range of movement, muscle weakness, joint instability, difficulty performing daily activities and household activities, and low mood. It has several comorbidities including sleep disturbance, anxiety, depression, and feelings of helplessness that reduce quality of life. OA affects over 7% of the global population, and 10% of the global population aged 60 years and older. Women are affected more than men, and clinical outcomes are poorer. There is no cure for OA, and treatment is aimed at managing the symptoms such as pain and maintaining joint mobility and functionality, with joint replacement for end-stage OA. Current pharmacological interventions have limited efficacy. Preclinical evidence supports the contention that medicinal cannabis (MC) and key components including cannabidiol (CBD), tetrahydrocannabinol (THC), and some terpenes might assist in alleviating pain and other symptoms associated with OA. There is substantial clinical evidence that MC has analgesic actions within the general pain literature, and evidence that cannabinoids may be useful in the treatment of common comorbidities of OA such as anxiety and insomnia. Animal models of OA indicate CBD are effective in reducing joint pain and may have a protective effect on cartilage. Surveys suggest that MC is useful to people with OA, but clinical evidence is limited, albeit promising. There are only a few case studies published on CBD/THC combination products, and a small number of clinical studies into CBD, two RCTs investigating topical CBD, and one RCT investigating the use of oral CBD isolate as an adjunct therapy. There is one case-control study into hempseed oil and terpenes. In relation to studies investigating MC products more broadly for OA (including those containing THC), there is one prospective cohort study focused on impact on opioid use, a retrospective review investigating the impact of cannabis use on arthroplasty outcomes and one systematic review. In general, this scientific evidence is cautiously supportive of consideration of MC as a treatment option, but more research is needed to investigate the efficacy and effectiveness of different MC products and their effects not only on pain but also for other comorbidities of OA.