This study sought to clarify the perceptions and meanings of chronic knee joint pain, as well as the factors that affect them, among elderly people living in rural areas in order to obtain suggestions for improved nursing care. Semi-structured interviews were conducted with 14 elderly people living in rural areas with a history of chronic knee joint pain for at least 1 year. The interview data were then qualitatively and inductively analyzed. Participants were recruited from the Federation of Senior Citizens' Clubs and outpatient internal medicine clinics. The perceptions of knee joint pain of elderly people living in rural areas were found to have features of perceptions measured according to the need for medical care, perceptions in relation to daily life, and perceptions of oneself as a person with knee joint pain. To these elderly people, knee joint pain meant “something that raises awareness of one's remaining time in life,” “something that can't be helped in life”, and “proof that one has worked hard in life.” Perceptions and meanings of knee joint pain were influenced by “not being impeded in behavior related to excretion” and other areas of life. It is important that nursing professionals support elder ly people so that they are capable of proper self-care and ensure that elderly people are “not impeded in behavior related to excretion.” In addition to providing support for symptoms of knee joint pain and behavior, nurses need to proactively ask elderly people to talk about their experiences of having knee joint pain, and determine and provide the nursing care considered necessary at that stage while considering individual elderly persons' perceptions and meanings of knee joint pain.