Rheumatoid arthritis is a common disorder that does not have the favorable outcome it was once thought to have. A detailed clinical history, thorough physical examination, and judicious use of serologic tests and radiologic studies should allow accurate diagnosis, even at an early stage. Traditional therapy can successfully improve short-term functional status but may not alter long-term outcome. Early, aggressive therapy may improve prognosis, but this approach must be further studied and, if attempted, should be done in consultation with a rheumatologist.