Osteoarthritis (OA) is a degenerative joint disease characterized by redness, swelling, heat, pain, functional impairment, and joint deformities. In severe cases, it can lead to joint disability and affect quality of life. However, the pathogenesis of OA is still unclear, but studies have shown that the signaling pathway dominated by ceramide-1-phosphate can lead to joint pain, inflammation, and degeneration. Therefore, this article summarizes and analyzes the pathogenesis of OA dominated by the ceramide-1-phosphate signaling pathway, aiming to provide references for future research.