At the request of the Confederation of Healing Organizations (CHO) the addition of spiritual healing (SH) to conventional therapy has been compared with conventional therapy alone in 29 patients with rheumatoid arthritis (RA) using a parallel group design. Clinical and biochemical assessments were recorded at intervals while subjects received a 6-month course of spiritual healing. Initial psychological assessment was also performed. The addition of SH produced no significant improvement in any of the relevant clinical or laboratory parameters assessed; although groups were not exactly matched at the start, those requesting SH had more active disease. Between-group comparison showed only an improvement in summated change score (SCS) in favour of SH at week 16, which was lost by week 24. Individuals displaying the most improvement in pain score or SCS with SH did not have a significantly different psychological profile from those patients who showed the most deterioration. Although our study was small the results do not persuade us to proceed to a larger study for which there would be difficulties in study design.