Background: Total joint replacement is the most effective and a successful treatment for the elderly patients suffering from end stages of osteoarthritis .The aim of this study was to assess knowledge and concerns of elderly patients regarding the total joint replacement surgery. Methodology:A descriptive design was utilized to conduct this study which was conducted in the orthopedic outpatient clinics at the Zagazig UniversityHospitals. The sample included 103 elderly patients. Tool used for data collection was a structured interview questionnaire which composed of five parts; Demographic characteristics of the elderly patients, general medical history, history of osteoarthritic elderly patients, concerns about total joint replacement surgery and elderly patient s’ Knowledge regarding total Joint replacement.Results: the present study revealed that, there was 86% of the studied elderly patients had high concerns of TJR surgery and 98.1% had unsatisfactory knowledge about total joint replacement, while only 1.9% had satisfactory knowledge about it. A statistically significant relation between educational levels (illiteracy), concerns of elderly patients and total joint replacement knowledge. Conclusion: The majority of elderly patients wasilliterate, had unsatisfactory knowledge and had high concerns of TJR surgery. Recommendations: Developing educational programs to improve elderly patients' knowledge of the importance and effectiveness of surgery and alleviate their concerns. Keywords: Total joint replacement, Elderly patients, Concerns, Knowledge