BACKGROUND: Knee pain is the main symptom of knee osteoarthritis. Walking is effective against knee pain, and some studies have shown that gait modification can also relieve this condition. However, the quality of evidence for the clinically significant effects of gait modification on knee pain has not been examined. OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the level of evidence for the clinically significant effects of gait modification on knee pain and determine if the effects are greater than the minimal clinically important difference (MCID). METHODS: We comprehensively searched electronic databases such as MEDLINE, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database, and Cumulative Index to Nursing and Allied Health Literature. Intervention studies with experimental groups who received gait modification and control groups who did not were evaluated. The Grading of Recommendations Assessment, Development and Evaluation system was used to assess the level of evidence. RESULTS: Nine studies met the inclusion criteria. All were included in the systematic review and two in the meta-analysis. Results showed that gait modification have significant effects (p= 0.02), and the quality of evidence was very low. However, several studies have revealed that the effects of gait modification, when used as a foot-focused intervention, were greater than the MCID. CONCLUSIONS: We concluded that there is a lack of high-quality evidence that supports the general efficacy of gait modification. Although based on low-quality evidence, when applied to the foot, it may have clinically significant effects.