The opinion of patients expressed in terms of satisfaction is extremely important in any evaluation of total knee arthroplasty (TKA) results. The primary endpoint of this study was to determine the quantitative and qualitative expectations of elderly patients before undergoing TKA. Cross-sectional study of 497 patients over 65 years was performed before TKA. Main variables collected: demographic, functioning, pain, comorbidity, depression and expectations assessed with the Hospital for Special Knee Replacement Expectation Survey. Statistical tests used were: Student's t-test, analysis of variance, Spearman's ρ and multivariate regression analysis. The means of the total and maximum expectations were 12.3±1.63 and 9.5±1.78 (±S.D.), respectively. Between 90 and 100% of patients referred expectations to improvement regarding pain, basic functional activities (walking, climbing stairs, knee mobility, general mobility) and general well being. There were statistically significant correlations with age (r=-0.321), pain before operation (r=-0.206), expected pain at 6 months (r=-0.206), depressive symptoms (r=-0.180) and the Barthel index (BI) (r=0.154). One can conclude, that the expectations of improvement among patients before TKA are high and may be classified as expectations of improvement of pain, basic functional activities and general well being. Age, pain intensity and presence of depression correlate inversely with the amount of expectations.