Klebsiella pneumoniae septic arthritis in elderly patients with liver cirrhosis is rare. We describe a 65-year-old cirrhotic male who suffered initially from bronchopneumonia. However, a painful disability of the left knee developed three days later. K. pneumoniae was immediately cultured from the blood and then isolated from the joint fl uid two weeks later by repeated arthrocentesis. Arthroscopic irrigation with closed tube drainage was arranged immediately with good recovery.These fi ndings highlight the importance of repeated synovial fl uid analyses in cirrhotic patients with septicemia and persistent swollen, painful joints for early diagnosis of septic arthritis. Here, we report a rare case of K. pneumoniae septic arthritis of the knee in a cirrhotic patient.