Pigmented Villonodular Synovitis (PVNS) is a joint disorder characterized by benign but locally aggressive proliferation of the synovial membrane. The localized form is rare, and its nonspecific symptoms make diagnosis challenging. We report a case of localized PVNS of the knee in a 47-year-old man. Arthroscopic resection resulted in complete recovery, with total and permanent resolution of symptoms and no recurrence.