Musculoskeletal conditions are very common across Europe. They affect all age groups, and the associated physical disability is an enormous burden on individuals and society. They can be effectively prevented and controlled in many situations, but this is not at present fully achieved. This report outlines what is required to achieve this and the role of rheumatology in providing these healthcare services. Strategies are given for the prevention and management of musculoskeletal conditions. The needs of people with these conditions are expressed in the PARE Manifesto and the clinical needs have been identified. The healthcare services required to implement these strategies and meet these needs are considered focusing on what services a rheumatology centre should provide. A key principle is that management of musculoskeletal conditions requires a coordinated, integrated, multidisciplinary and multiprofessional approach providing access to a combination of expertise and competencies. Guidance is given of what a rheumatology service should be expected to offer. For a rheumatology centre to provide these services, the need for appropriate facilities and resources is identified, which considers physical resources as well as personnel, training and management needs. Maintaining high standards of care and achieving the best outcomes at all times needs the monitoring of quality indicators as well as ongoing education and research. In conclusion, improving musculoskeletal health is dependent on access to effective treatments and this document shows how the services provided by a rheumatology centre is central to this.