Osteoarthritis (OA) is the most common form of arthritic disease, and it is a major cause of disability and impaired quality of life in the elderly. A hallmark of the disease is progressive degeneration of articular cartilage and subsequent joint space narrowing. However, OA is a complex disease not limited to cartilage degeneration, but involving also synovial membrane and subchondral bone, thereby presenting alternatives approaches for treatment. In this paper, we propose a short review of the recent advances in the understanding of the role played by subchondral bone in OA.