Background: Patient compliance to home exercise programs is significantly linked to improved treatment outcomes. Finding ways of encouraging patient conformity to these programs is imperative. For patients with osteoarthritis (OA) of the knee, a condition that causes pain, disability and lessens the quality of life, exercise is essential for effective control of the condition. Aim: to investigate the effectiveness of multimedia messaging services (MMS) in improving patient adherence and functional outcome to home based exercise programs for patients suffering from knee OA. Methods: Fourteen patients diagnosed with knee OA and were referred to an exercise group therapy (for a total of six sessions) participated in this pilot study. The patients were randomly assigned to either the research or control group. The research group received MMS messages additional to the exercise sessions (video of exercises up to 10 seconds in length) to their mobile phone. Outcome measurement included the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire, combined Focus On Therapeutic Outcomes (FOTO) questionnaire, Visual Analog Scale for Pain (VAS), Fear-Avoidance Beliefs Questionnaire (FABQ) and a general questionnaire. Results: The research group had baseline scores representing slightly higher disability, pain and fear avoidance than the control group as observed by the lower FOTO score and the higher FABQ, VAS and WOMAC scores. Analyzing the difference between initial and final scores revealed that the research group had a slightly higher perceived functional improvement. Conclusions: This study addressed the feasibility of short video messaging via mobile phones in increasing compliance to home exercise programs prescribed to patients suffering from knee OA. This pilot study provides an indication for the potential of success and a larger sample study should be conducted.