Knee osteoarthritis (OA) significantly affects quality of life and poses substantial treatment challenges in patients with severe comorbidities that contraindicate total knee arthroplasty. Transarterial periarticular embolization (TAE) has developed as a minimally invasive alternative targeting pathological periarticular hypervascularity. Bilateral embolization in a single session has not yet been clearly documented. This case report describes the application of bilateral genicular artery embolization using bioresorbable gelatin microspheres. : A 68-year-old male patient with severe bilateral knee OA and multiple cardiovascular comorbidities underwent simultaneous bilateral TAE using Nexsphere-F microspheres (100-300 µm). Embolization targeted hypervascular genicular branches identified through digital subtraction angiography preserving normal capsular and osseous perfusion. : At one-month follow-up, the patient's pain score decreased dramatically (VAS from 8/10 to 2/10), accompanied by marked functional improvement (WOMAC score: from 64 to 84; KOOS score: from 49 to 72). No intraoperative or postoperative complications occurred and the patient required no analgesics post-procedure. : Bilateral, same-session genicular artery embolization using bioresorbable gelatin microspheres provided short-term clinical benefits in a patient with advanced knee OA contraindicated for surgery.