Objectives: The objective of this study was to assess the outcomes and the patient satisfaction after total knee replacement (TKR) by Oxford knee score (OKS). Methods: We included 71 individuals from King Fahad Armed Forces hospital western region of Saudi Arabia who had unilateral and bilateral TKR done in 2009-2010, then assessed their OKS 5 years post-operatively. The estimation of the satisfaction level after TKR was performed by asking individuals the question ‘Are you satisfied with your knee replacement’? and the possible answers were Yes or No. Results: There were 39 male patients (55%) and 32 female patients (45%), with a mean age of 64.5 (SD 10.9, range 32–90) years. Approximately 94.4% of the patients are above 50 years. The mean OKS in both sex was 32.5 (range, 1-48; SD, 9.9) 5 years post-operatively. Mean OKS in male was 35.2(SD, 9) while mean OKS in female was 27.5 (SD, 10.5). Only 18 of 71 (25.3%) patients had a score of > 40 (excellent grade of OKS). Thus, 18 of 71 (25.3%) patients reported no or barely any problems with their TKR. 7% of the patients (5 of 71) were unsatisfied with the knee surgery. While 93% of the patients (66 of 71) were satisfied. Conclusion: Patients who were satisfied with knee replacement had a higher score (better) than unsatisfied patients. The OKS was lower in females. We can say that OKS is a good tool to measure the outcome after TKR and predict the patient satisfaction. Valid patient-reported questionnaires to measure the outcome will be of worth in large multicenter studies that are needed to identify agents affecting the outcomes of TKR. However, with a small sample size, caution must be applied and not over-interpret these data, as the findings might not be extrapolated to all patients.