Developments in cellular imaging now enable the real-time visualization of the choreographed sequence of events that underlie the development of immune responses in vivo. The previously unappreciated dynamics and anatomical context of cellular interactions, revealed in these studies, can have profound consequences for the 'decision' by the immune system to induce immunological priming versus immunological tolerance. Importantly, dysregulation of this balance can result in autoimmune diseases such as rheumatoid arthritis (RA). By further developing our understanding of how, where and when cells interact during immune responses, we can further dissect these events to assess how cell interactions might be aberrant in autoimmunity. A better knowledge of the mechanisms involved in cellular interactions by means of cellular imaging can help the development and targeting of therapies to particular disease stages and tissues in patients with RA in efforts to restore immune homeostasis.