This study evaluates the American Rheumatism Association criteria for remission in rheumatoid arthritis (RA) using data gathered prospectively in 2 distinct patient groups: Americans (n=181) and Peruvians (n=44). The criteria were found to be highly specific in both patient groups but the sensitivity of the criteria was low in the American patients. The criteria most frequently not satisfied in the American patients with RA were subjective. Several explanations are offered: differences in disease severity, problems in using a translated questionnaire, differences in practice level among rheumatologists, but none of them fully explain the lower sensitivity of the criteria among the American patients.