ABSTRACT: BACKGROUND: Osteoporosis is a major co-morbidity in rheumatoid arthritis (RA). Bone mineral density (BMD) in adults can be assessed precisely by dual-energy x-ray absorptiometry (DXA). In recent years, quantitative ultrasound (QUS) technique has been used in radiation-free assessment of bone density by mean of ultrasound waves attenuated by bone. OBJECTIVE: The aim of study was to compare QUS to DXA in assessing BMD in patients with RA. PATIENTS AND METHODS: Fifty women with RA (diagnosed according to ACR criteria) of 2-12 years duration, their ages range from 30-72 years, who were seen at Osteoporosis Clinic in Baghdad Teaching Hospital were recruited. Sixty four percent were or had been receiving glucocorticoid treatment. All patients receiving disease modifying anti-rheumatic drugs (DMARDs). Lumbar spine BMD was measured by DXA, and QUS for calcaneum was performed in all patients. RESULT: T-scores measured by QUS were correlated significantly with lumbar spine BMD T-scores measured by DXA (p<0.0005). Bone mineral density T-scores were negatively correlated with age and disease duration. Patients taking glucocorticoids were associated with lower T-scores. CONCLUSION: The findings of this study support QUS as an alternative tool for assessing BMD in patients with RA.