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Objective To compare the clinical efficacy of methotrexate(MTX) combined with acupuncture and methotrexate treatment in patients with active rheumatoid arthritis(RA) . Methods From July 2017 to July 2018, a total of 80 patients with active RA, being eligible for inclusion criteria,were collected. According to incomplete randomized method by the end number of hospitalization, patients with uneven number were divided into experiment group ( n = 40) and treated with MTX(sig.10 mg po. qw. ) combined acupuncture( moxibustion Shenshu,Zusanli, Yanglingquan, Ashi points + moxibustion), while patients with even number were divided into control group (n = 40) and treated only with MTX(sig. 10 mg po. qw.). Before and during the six months of treatment, laboratory indicators, visual analogue scale(VAS) score of pain and satisfaction degree of patients were evaluated. Six months after treatment, treatment efficacy was evaluated, and degree of remission was also evaluated by using disease activity score in 28 joints(DAS28). Results Among all patients, there was no withdrawal from liver and kidney dysfunction. Levels of aspartate aminotransferase, alanine aminotransferase, creatinine, and blood urea nitrogen were with an increasing trend with the prolonging of treatment time. While levels of erythrocyte sedimentation rate, C reactive protein, rheumatoid factor and VAS score of pain were with an decreasing trend, and those of experiment group were superior to control group ( P< 0. 05). Satisfaction degree of experiment group was better than control group( P< 0. 05). Six months after treatment, the effective rates of experiment group and control group were 87. 50% and 65. 00% respectively,and with statistical difference(P < 0. 05),and the number of patients with RA relief according to the DAS28 score was higher than control group( P < 0. 05). Conclusion The effect of MTX combined with acupuncture on RA could be better than single MTX treatment, and could be with more efficiency to relieve the disease condition and pain of patients. [ABSTRACT FROM AUTHOR]