My case is one in which the principal manifestation of rheumatoid arthritis is pleurisy. It is a case that underscores the clinical nuances of rheumatoid pleuritis. The major articles that have shaped our view of rheumatoid pleuritis are discussed in light of my case, a perspective that raises the possibility that some of the established biases about rheumatoid pleuritis may be misleading. It is necessary to consider rheumatoid pleuritis in any patient with an unexplained pleural effusion.