RHEUMATOID ARTHRITIS (RA) IS A chronic inflammatory arthritis involving 0.5% to 1% of the US population. This disease affects women twice as often as men and its incidence rises with increasing age. In general, RA causes a symmetric polyarthritis affecting large and small joints in association with systemic manifestations, such as morning stiffness, fatigue, and weight loss. Although considered a joint disease, RA can have widespread effects on the entire body and can impair life expectancy by as much as 5 to 10 years. With progressive disease, patients with RA develop work disability, functional impairment, and radiographic evidence of joint damage. While many conditions can produce polyarthritis, the diagnosis of RA can usually be established by the presence of persistent joint pain, swelling in a symmetric distribution, and prolonged morning stiffness. Supporting the diagnosis are laboratory findings, such as a positive test result for rheumatoid factor. The intensity of joint inflammation often correlates with the erythrocyte sedimentation rate or levels of serum C-reactive protein, but these abnormalities are nonspecific. In the management of RA, the primary care physician plays an important role by ensuring early diagnosis. If unsure about the presence or significance of synovitis, the primary care physician should consult a rheumatologist for this determination. The management of RA has undergone a revolution in the past decade, reflecting a growing armamentarium of drugs and a shift in treatment strategies. While RA is a chronic condition, joint damage occurs at onset for many patients. Thus, in the current strategy, which has replaced the older, more gradualist treatment pyramid, therapy is begun immediately to control disease activity, reduce functional impairment, and prevent irreversible changes in cartilage and bone. Since prompt disease control is a major goal of therapy, the primary care physician should consider referring a patient with suspected RA to a rheumatologist for early treatment. A variety of surgical procedures is also available to reduce joint pain and improve function, but a discussion of these modalities is beyond the scope of this article.