Four treatment objectives govern the management of rheumatoid arthritis (RA): to control the clinical manifestations, to prevent structural damage, to prevent functional impairments, and to reduce excess mortality. Disease activity determines the extent of structural damage, the severity of functional impairments, and in part the excess mortality related to cardiovascular disease. In established RA, the functional impairments depend also on the extent of the structural damage. Methods for assessing disease activity, treatment responses, structural damage, and functional impairments are reviewed herein. A standardized follow-up protocol is suggested as a means of achieving greater uniformity in clinical practice.