Among the panoply of cells in the rheumatoid synovium, increasing attention has been directed toward non-T cell elements as potential therapeutic targets. While the precise role of T cells as initiators or perpetuators of rheumatoid arthritis (RA) is difficult to quantify, there is little disagreement that macrophages and fibroblasts play an essential part in the destructive aspects and cytokine networks of the disease. This review is designed to examine the biology of the synovial intimal fibroblast in RA and how it participates in this process. Moreover, understanding its role in the pathogenesis of RA offers a variety of novel approaches to controlling both the inflammatory and destructive aspects of arthritis.