Joint involvement is one of the most frequent clinical complications of acromegaly. The aim of this study was to evaluate the femoral cartilage thicknesses of acromegalic patients using ultrasound (US). Sixty-two patients diagnosed with acromegaly (30 F, 32 M) were included. Patients' demographic and clinical characteristics were recorded. The thickness of the femoral articular cartilage was measured using a 6- to 18-MHz linear probe. Measurements were performed bilaterally from three points (medial condyle, intercondylar area, and lateral condyle). Of the patients, 14 (22.5 %) reported pain in the knee joints. A significantly higher femoral articular cartilage thickness was determined in the patients compared with the controls (all parameters, p < 0.001). US measurements results from all points were consistent, but these values were not correlated with levels of growth hormone (GH) and insulin-like growth factor-1 (IGF-1). Analysis of acromegaly patients as active (n = 37) or inactive (n = 25) revealed no significance with respect to femoral cartilage thickness. Acromegalic patients seem to have thicker femoral articular cartilages irrespective of disease activity state.