The adhesion mechanisms that enable leukocytes to migrate from the blood and function within inflamed synovium continue to occupy an area of intense investigation. Over the past year, advances have been made in understanding the specialized roles that individual adhesion molecules play in the interactions between leukocytes and vascular endothelial cells in inflammation in general. Several articles have described the expression of novel adhesion molecules in rheumatoid synovium, and a number of reports on the measurement of soluble adhesion molecules in blood and in synovial fluid have appeared, although it is too early to know whether this is clinically useful. Finally, inhibiting adhesion molecule function in vivo remains an attractive option for anti-inflammatory therapy.