Biologicals are often thought to increase the risk of infection. A recent review shows that the risk of serious infection in patients with rheumatoid arthritis being treated with biologicals (standard dose) is only mildly elevated compared with those who are treated with conventional DMARDs only (odds ratio: 1.3). If biologicals are used at a lower dosage, e.g. tapering studies, the risk of serious infection does not seem to be increased. Alertness for infection in these patients, dose tapering and preventive measures such as vaccination, patient education and tuberculosis screening may potentially further reduce this serious side effect of biologicals.