Immunogenetic differences between American blacks and Caucasians have been described but a comparison of clinical and radiologic features between both groups has been lacking. Eighty-four American black and 166 Caucasian patients were randomly selected from our computer database and relevant clinical and demographic information obtained from records and interviews. Both groups were similar demographically, and no significant clinical differences were observed with regard to disease duration, frequency of extraarticular manifestations, use and toxicity from disease modifying antirheumatic drugs, RA related surgical procedures, disability, fatality rate and functional outcome. Our results suggest that seropositive RA is clinically and radiographically similar in both groups.