Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory disorder characterized by synovial hyperplasia and resulting joint destruction. Total Knee Arthroplasty (TKA) is the gold standard treatment for patients with advanced osteoarthritis but in RA it poses some unique challenges. We have studied the outcome and complications in patients of RA undergone total knee arthroplasty Aim & Objectives: To study the midterm outcome and complications of total knee arthroplasty in patients of rheumatoid arthritis Material & Methods: This was a retrospective study of 148 total knee replacements performed in 89 patients with rheumatoid arthritis. Our study was a single centre study. Patients were enrolled into study based on the scrutiny of hospital’s operative records. Results & Observations: In 58 patients (64.44%) arthroplasty was performed for their both knees in single stage. Pain is the main complaint of all RA patients. 52% patients had varus deformity, 22.3% had valgus deformity, and rest didn’t have any deformity in coronal plane. 40.5% knees had fixed flexion deformity. KSS and functional outcome is good if intra operatively we found injury to extensor mechanism or major deformity correction required by extra bony as well as soft tissue procedure. Conclusions: TKA is a procedure which significantly reduce the pain due to rheumatoid arthritis and increase the ROM in patients who were having FFD or ROM less than 90o. Intraoperative complication like injury to collateral ligaments, extensor tendon injury, fractures are common in patient with Rheumatoid Arthritis