We review the literature and analyze data from the National Health Interview Survey to provide estimates of the economic cost and social impacts of the rheumatic diseases in the United States. Rheumatic diseases had an economic impact in 1980 of 21 billion dollars due to expenditures for health care and lost wages, an amount equal to 1% of gross national product. These conditions are responsible for 5% of all hospital discharges, 10% of all hospital procedures, and 9% of all physician visits. They are also responsible for over 2 million persons being unable to do major activities, for 5 million being limited in other ways, and for at least 1 million being severely limited in the ability to perform activities of daily living. As great these impacts would appear to be, they are likely to grow since the aging of the population increases both the prevalence and severity of impact of the rheumatic diseases.