The study was open randomized trial with standard control. The diagnosed cases of Wajaul Mafasil (OA) were randomly allocated to test and control groups. 4 leeches on each knee were locally applied on 0, 3rd, 9th, 15th, 21st and 27th day and in control group Piroxicam 20 mg once daily was administered for the same duration. Treatment protocol was followed for 28 days and assessment of pain, tenderness, restriction of movement, morning stiffness and swelling was noted at 0, 14th and 28th day. The assessment was done through visual analogue scale (VAS) score for both the groups. The comparison of the groups for VAS was done by using Kruskal-Wallis test with post hoc Dunn’s multiple pair comparison test. The study showed that Taleeq (Leech therapy) helps to relieve symptoms in patients with osteoarthritis of the knee and there was definite reduction in the cardinal symptoms of Wajaul Mafasil.