Rheumatoid arthritis is the most common inflammatory joint disease. It is characterized by a proliferative synovitis that symmetrically affects several joints and, if not promptly diagnosed and treated, leads to severe joint destruction. Shoulder involvement by rheumatoid arthritis is very common, affecting more than half of the patients and almost all patients with long-standing disease have their shoulder joints severely damaged. As a result of joint destruction patients present significant shoulder pain, upper limb impairment and, consequently, a decreased quality of life. Shoulder arthroplasty has shown to be a reliable treatment for patient with rheumatoid arthritis of the shoulder refractory to conventional therapy. Both significant pain relief and functional improvement have been delivered by this treatment modality and, therefore, patient’s quality of life is ameliorated. A careful preoperative assessment and an early referral to an orthopedic surgeon are paramount in order to properly plan joint replacement and avoid complications.

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