In a review of 100 consecutive patients with adult rheumatoid arthritis (RA), clinical evidence of liver disease was absent, whereas minor abnormalities of liver biochemistry, mainly a raised alkaline phosphatase, were present in 32 cases. Liver biopsies were obtained in eight patients; the most striking finding was the presence of sinusoidal dilation in all samples, with a normal central vein and preservation of hepatic architecture. The mechanism of this nonspecific histological change is not known, though it could be speculated to be secondary to a humoral factor related to RA. We conclude that hepatic involvement in adult RA is common but trivial and that routine liver biopsy is not indicated.