We assessed whether higher body mass index (BMI) is associated with higher risk of moderate-severe knee pain 2 and 5 years after primary or revision total knee arthroplasty (TKA). We adjusted for sex, age, comorbidity, operative diagnosis, and implant fixation in multivariable logistic regression. Body mass index (reference, <25 kg/m 2 ) was not associated with moderate-severe knee pain at 2 years postprimary TKA (odds ratio [95% confidence interval], 25-29.9, 1.02 [0.75-1.39], P = .90; 30-34.9, 0.93 [0.65-1.34], P = .71; 35-39.9, 1.16 [0.77-1.74], P = .47; ≥40, 1.09 [0.69-1.73], [all P values ≥ .47]). Similarly, BMI was not associated with moderate-severe pain at 5-year primary TKA and at 2-year and 5-year revision TKA follow-up. Lack of association of higher BMI with poor pain outcomes post-TKA implies that TKA should not be denied to obese patients for fear of suboptimal outcomes. © 2011.