30 patients with rheumatoid arthritis were treated with a weekly low dose of Methotrexate for a period of 12 months. In the course of treatment there was significant improvement in pain and mobility, in the number of inflamed joints and use of steroids. There was a fall in erythrocyte sedimentation rate and hemoglobin content rose significantly. 81% of the patients improved. Of these 14% had a complete clinical remission. There were 19% non-responders. Adverse reactions developed in 13 patients (43.3%, gastrointestinal symptoms, elevated liver enzymes, loss of hair, stomatitis). After decreasing or temporary discontinuing in 10 of them the drug was taken again later on. It had to be withdrawn in 3 patients (10%). All recovered when Methotrexate was discontinued. It is concluded that low dose Methotrexate is effective in the long term treatment of chronic rheumatoid arthritis.