In the past 20 years, the life expectancy of patients with rheumatoid arthritis (RA) has been shown to be reduced by three to ten years as compared to that of the general population. Currently, cardiovascular disease (CVD) is the major cause of death in patients with RA, and acute myocardial infarction can be up to four times more frequent in these patients. The autoimmune systemic inflammatory response, along with the presence of metabolic syndrome (MetS), doubles the risk for fatal or non-fatal CVD and coronary atherosclerosis, regardless of age and sex. Rheumatoid arthritis has been associated with increased prevalence of MetS, but its role in the different characteristics of the disease, such as disease duration, activity, and treatment with glucocorticoids, is not well defined. This study aimed at reviewing the prevalence of MetS and the factors implicated in the development of atherosclerosis in RA patients, assessing the clinical aspects of RA and its association with the development of MetS.