Background: Total Knee Arthroplasty (TKA) is an effective surgical intervention for end-stage knee osteoarthritis. With the rising prevalence of obesity, an increasing number of obese patients are undergoing TKA. Obesity has been associated with altered functional recovery and higher complication rates; however, outcomes remain variable across studies, particularly in the Indian population. Objectives: To compare the clinical and functional outcomes of Total Knee Arthroplasty in obese versus non-obese patients and to assess postoperative complications associated with obesity. Materials and Methods: This prospective observational study was conducted at Maratha Vidya Prasarak Samaj’s Dr. Vasantrao Pawar Medical College, Hospital & Research Centre, Nashik, from March 2024 to February 2025. A total of 100 patients undergoing primary TKA for knee osteoarthritis were included and categorized into obese (BMI ≥30 kg/m²) and non-obese (BMI <30 kg/m²) groups. Patients were evaluated preoperatively and postoperatively for functional outcomes, range of motion, early ambulation, and complications. Comparative analysis was performed between the two groups, and a p-value <0.05 was considered statistically significant. Results: Of the 100 patients, 46% were obese and 54% were non-obese. Both groups showed significant postoperative improvement; however, non-obese patients achieved higher mean postoperative functional scores (82.9 ± 7.6 vs 78.4 ± 8.2), greater knee range of motion (114.2° ± 8.6° vs 108.6° ± 9.4°), and earlier independent ambulation (85.2% vs 73.9%). The overall complication rate was significantly higher in obese patients (26.1%) compared to non-obese patients (7.4%), with wound-related complications being more common in the obese group. Conclusion: Total Knee Arthroplasty provides substantial clinical and functional improvement in both obese and non-obese patients. However, obesity is associated with comparatively reduced functional outcomes and a higher risk of postoperative complications. Careful patient counseling, optimization of comorbidities, and meticulous perioperative management are essential to improve outcomes in obese patients undergoing TKA