Background: Rheumatoid arthritis (RA) is an auto-immune inflammatory arthritis globally affecting 1% of the population. This study was conducted to see prevalence of carpal tunnel syndrome in patients of RA and its association with disease severity. Methods: One-hundred-fifty-four patients aged 21?80 years, of both gender, with RA were enrolled using non-probability consecutive sampling technique. Patients were divided into two groups of 77 each: active disease group (DAS-28 score >3.2) and LDA/remission group (DAS-28 score ?3.2). RA was defined according to the 2010 ACR Diagnostic Criteria for Rheumatoid Arthritis. Disease severity of RA was determined according to DAS-28 score. Carpal tunnel syndrome (CTS) was diagnosed clinically by specific symptoms and clinical signs. Data were analysed using SPSS-25. Results: Mean age of the patients was 43.6±13.7 years, 102 (66.3%) were female. Mean disease duration was 8.3±6.1 years, and mean DAS-28 score was 4.3±2.1. RA factor was positive in 98 (63.7%) and Anti-CCP antibody in 79 (51.3%). CTS was present in 49 (31.8%) patients. On stratification, CTS was seen in 32 (41.5%) patients with active disease compared with 17 (22.1%) patients with LDA/remission. No statistical association of CTS was seen with age, gender, disease duration, RA factor positivity, Anti-CCP antibody positivity and disease severity. Conclusion: Carpal Tunnel Syndrome was seen in about one-third patients with RA but no statistically significant association was seen with age, gender, disease duration, RA factor or Anti-CCP positivity and disease activity. Pak J Physiol 2023;19(4):32–5