Rheumatoid arthritis (RA) is often regarded as a non-fatal disease. Yet patients with RA have a substantially reduced life expectancy. Increased mortality in RA is associated with a long disease duration, with severe disabling arthritis and with systemic involvement. Patients with chronic RA are particularly at risk of death from bacterial infection and renal disease. The influence of treatment on mortality remains unclear. In patients with mild RA, the treatments may be more toxic than the disease.