Rheumatology in Iran started in the 1960s by a group of eight rheumatologists trained in France and Switzerland. The Iranian Rheumatology Society was founded in 1973. Academic rheumatology started in the city of Teheran (capital of Iran), by the Tehran University and by the National University in the '60s. Later, Shiraz University and Mashhad University followed. After the creation of the subspecialty Board of Rheumatology in 1985, other universities gradually created their rheumatology sections with the help of newly trained rheumatologists. The first subspecialty rheumatology outpatient clinic was created in 1970, in Tehran. In 1973, rheumatology was recognized as an internal medicine subspecialty for the training of medical students. Thus, one-eighth of internal medicine training was allocated to rheumatology. The subspecialty Rheumatology National Board was created in 1985. Four medical universities were approved for the training of rheumatology fellows. They were Tehran University, Beheshti University, Iran University, and Shiraz University of Medical Sciences. From 1985 to 2008, more than 150 rheumatologists got their Board of Rheumatology subspecialty. Thirty-seven medical universities in Iran have a rheumatology section. The prevalence of musculoskeletal complaints in people aged 15 years and over, is 41.9% in urban areas and 66.6% in rural areas (P < 0.001). Two major ethnicities live in Iran; Caucasians (71.4%) and Turks (23.1%). Musculoskeletal complaints are more frequent in Turks than in Caucasians (46%vs.40.8%, P < 0.001). Men complained less than women in urban areas: 34.1% versus 50.2% (P < 0.001). The same was seen in rural areas: 51.6% versus 72.4% (P < 0.001). The most frequent complaints were (urban vs. rural): knee (25.5%vs. 39.2%), dorsolumbar spine (21.7%vs. 41.9%), shoulder (14.5%vs. 22.7%), and cervical spine (13.4%vs. 17.9%). The distribution of mechanical diseases was: low back pain (15.4%vs. 23.4%), osteoarthritis (16.6%vs. 20.5%), and soft tissue rheumatism (4.6%vs. 2.2%). The distribution of inflammatory diseases was: rheumatoid arthritis (0.33%vs. 0.19%), seronegative spondylarthropathies (0.23%vs. 1.1%), and systemic lupus erythematosus (0.04%vs. 0.06).