Rheumatoid arthritis is a chronic autoimmune inflammatory disease associated with multiple metabolic alterations and increased cardiovascular risk. It is supposed that visceral obesity seems to be a connection between rheumatoid arthritis and cardiovascular diseases. Obesity is not only associated with increased disease activity and worsened quality of life in this group of patients, but also determines the effectiveness of treatment. Biological therapy interferes with metabolic changes, too. Therefore, there is a tendency to select the right anticytokine preparation in the first line of treatment to reduce not only disease activity but also affect aspects of metabolic syndrome and comorbidites, thereby reducing cardiovascular risk and patients mortality. This work offers a basic overview of the associations between rheumatoid arthritis and metabolic disorders, describes the impact of biological therapy on individual components of the metabolic syndrome.