There have been three important double-blind studies evaluating the use of gold therapy in rheumatoid arthritis. Patients treated with gold have decreased number of joints with synovitis, decreased ring size, increased grip strength, and roentgenographic evidence of arrest or decrease in the progression of skeletal lesions. If a patient with active synovitis does not respond to nonsteroidal anti-inflammatory drugs after four months of treatment, he is a candidate for gold therapy. Maintenance gold therapy has been shown to sustain clinical improvement. Patients must be monitored with appropiate laboratory tests.