We evaluated the results of arthroscopic synovectomy of 11 rheumatoid elbows in 10 patients. All patients had severe pain and swelling, resulting from chronic synovitis, that had not responded to conservative treatment. We divided the patients into two groups according to preoperative Larsen grade: group A, grade 1, 2, or 3 (n = 6); and group B, grade 4 (n = 5). The visual analog scale and the Elbow Evaluation Sheet of the Japanese Orthopaedic Association were used for preoperative and postoperative evaluation of pain and function. Arthroscopy was performed by use of the procedure of Poehling et al, without resection of the radial head. The mean follow-up period was 37 months. Visual analog scale and Japanese Orthopaedic Association scores improved significantly in both groups, with relief of pain and satisfactory functional results. We recommend this procedure for patients with a persistently painful, swollen elbow with Larsen grade 1 to 4 due to rheumatoid arthritis.