With proper patient selection and perioperative planning, selective rearfoot arthrodesis in the patient with rheumatoid arthritis is effective in relieving pain and restoring ambulatory status. The overwhelming majority of current literature supports the early fusion of involved rearfoot joints in an effort to arrest the compensatory progression, which yields a rigidly deformed lower extremity. In keeping the patient with rheumatoid arthritis ambulatory, we can positively affect his or her quality of life and prevent the degradation into a sedentary disposition, and therefore heighten the long-term prognosis.