Pathology of the wrist is frequent in rheumatoid arthritis. The proper treatment leading to improvement in function and symptoms relief is of a big importance. The classification based on natural pattern of the disease is presented including three types: ankylotic, arthritic changes with artrodesis and instability leading to wrist collapse. It the third type it is important to add partial or total arthrodesis to the common synovectomy and ulnar head resection.