Objectives: To explore the adherence level, disability index and pain score in patients with RA and to understand the relationship between patient variables with adherence and Disability. Methods: A cross-sectional study with self-administered questionnaire to RA patients. Participants gave their consent and were recruited from outpatient pharmacy waiting areas in different tertiary hospitals in Riyadh, Saudi Arabia. This study Included (126) adults with RA. The questionnaire was given to patients and it contains three sections: (1) demographic and clinical data, (2) Adherence measured using 8-item Morisky Medication Adherence Scale (MMAS-8) by using validated Arabic version, (3) Health Assessment Questionnaire (HAQ). RESULTS: one-half the participants were (n=66) 52.3% non-adhered or show low adherence while (n=12) 9.5% of patients were adhered (high adherence).Those non-adhered almost (n=23) 18.2% of them shows low adherence after the first 5 years of diagnosis. About (n=35) 27.7% of none adhered had from 2-3 medications used for RA. There were no significant differences between clinical and demographic variables between groups. CONCLUSIONS: The vast majority of RA patients have low to medium adherence score. Advanced age, years of diagnosis and number of medication significantly affect disability score. However, there is no relationship between these factors and pain score.