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Pigmented villonodular synovitis is a rare disease that occurs on synovial tissue within and outside a joint. It can be localized or diffuse. Localized pigmented villonodular synovitis (LPVNS) can occur in any compartment of the knee joint. The aim of this study was to retrospectively analyze our consecutive series of LPVNS of the knee. From January 1999 to December 2018, 10 consecutive patients with LPVNS of the knee underwent surgical treatment at our department. All patients were arthroscopically treated by the senior author by removal of the localized mass and partial synovial resection of the area surrounding the bottom of the lesion. The series included four female and six male patients, mean age 29.5 (range, 17-60) years. Their symptoms prior to the operation lasted from 3 months to 3 years (mean, 11.8 months). At the mean follow-up of 110.9 (range, 11-239) months, none of the patients had recurrence of the disease. Our study confirms the consensus in the literature that LPVNS of the knee should be treated arthroscopically by excision of the localized mass and partial synovectomy of the area surrounding the base of the lesion.