Objective To investigate the effect of bilateral knee osteoarthritis (KOA) ondynamic balance ability of ankle strategy in aged women. Methods The dynamic balance ability tester was used to test the balance score, the rotation speed, the maximum rotation speed, and the percentage of the target ball's residence time in each area of KOA patients (KOA group)and the general elderly (control group), and a comparative analysis between groups was conducted. Results The balance score of KOA group was lower than that of control group; the dynamic balance control ability of KOA group in the horizontal direction was basically the same as that of control group, but the dynamic balance control ability of KOA group in the vertical direction was weaker than that of control group.Bilateral KOA reduced dynamic balance ability of ankle strategy in the aged women.It could not affect the left-right symmetric balance ability of the aged women, but it would reduce its forward-backward symmetrical balance ability. Conclusions Bilateral KOA aged women may be more likely to fall forward or backward, while not easy to fall laterally. For elderly female patients with bilateral KOA, methods such as strengthening ankle joint strength, proprioception and responsiveness can be used to prevent falls that may be caused by reduced dynamic balance ability, especially falls in the forward and backward directions.