SSirT1 is an NAD-dependent histone deacetylase that regulates gene expression, differentiation, development and organism life span. Here we investigate the function of SirT1 in human chondrocytes derived from osteoarthritic patients. Elevation of SirT1 protein levels or activity in these chondrocytes led to a dramatic increase in cartilage-specific gene expression, while a reduction in SirT1 levels or activity significantly lowered cartilage gene expression. SirT1 associated with the cartilage-specific transcription factor Sox9, enhancing transcription from the collagen 2(a1) promoter in a Sox9-dependent fashion. Consistent with this association, SirT1 was targeted to the collagen 2(a1) enhancer and promoter, which in turn recruited the coactivators GCN5, PGC1a and p300. This led to elevated marks of active chromatin within the promoter; acetylated histone K9/ K14 and histone H4K5 as well as trimethylated histone H3K4. Finally, alterations in the NAD salvage pathway enzyme nicotinamide phosphoribosyltransferase led to changes in NAD levels, SirT activity and cartilage- specific gene expression in human chondrocytes. SirT1, NAMPT and NAD may therefore provide a positive function in human cartilage by elevating expression of genes encoding cartilage extracellular matrix.