This review of the use of sulphasalazine (SASP) in the therapy of rheumatoid arthritis refers to the placebo-controlled trials of SASP and the randomized comparative studies with other second-line drugs that have been published over the past decade. The questions relating to appropriate selection of patients for this treatment and the possible relevance of drug interactions are addressed. The favourable effect of SASP on functional, radiological and extra-articular outcome measures is highlighted, as is the reproducibility of published studies. Finally, the results from combination studies and meta-analyses are outlined.