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Abstract Background Fibroblast-like synoviocytes (FLSs) are involved in osteoarthritis (OA) pathogenesis through pro-inflammatory cytokine production. TAK-242, a TLR4 blocker, has been found to have a significant impact on the gene expression profile of pro-inflammatory cytokines such as IL1-β, IL-6, TNF-α, and TLR4, as well as the phosphorylation of Ikβα, a regulator of the NF-κB signaling pathway, in OA-FLSs. This study aims to investigate this effect because TLR4 plays a crucial role in inflammatory responses. Materials and methods Ten OA patients’ synovial tissues were acquired, and isolated FLSs were cultured in DMEM in order to assess the effectiveness of TAK-242. The treated FLSs with TAK-242 and Lipopolysaccharides (LPS) were analyzed for the mRNA expression level of IL1-β, IL-6, TNF-α, and TLR4 levels by Real-Time PCR. Besides, we used western blot to assess the protein levels of Ikβα and pIkβα. Results The results represented that TAK-242 effectively suppressed the gene expression of inflammatory cytokines IL1-β, IL-6, TNF-α, and TLR4 which were overexpressed upon LPS treatment. Additionally, TAK-242 inhibited the phosphorylation of Ikβα which was increased by LPS treatment. Conclusion According to our results, TAK-242 shows promising inhibitory effects on TLR4-mediated inflammatory responses in OA-FLSs by targeting the NF-κB pathway. TLR4 inhibitors, such as TAK-242, may be useful therapeutic agents to reduce inflammation and its associated complications in OA patients, since traditional and biological treatments may not be adequate for all of them. Fibroblastlike Fibroblast like (FLSs (OA proinflammatory pro production TAK242, TAK242 TAK 242, 242 TLR blocker IL1β, IL1β ILβ IL1 β, β IL IL1-β IL6, IL6 6, 6 IL-6 TNFα, TNFα TNF α, α TNF-α NFκB NF κB pathway OAFLSs. OAFLSs FLSs. patients acquired TAK242. 242. TAK-24 (LPS RealTime Real Time PCR Besides pIkβα treatment Additionally TLR4mediated TLRmediated mediated inhibitors them TAK24 24 IL- TAK-2 TAK2 2 TAK-