BACKGROUND: Takayasu arteritis (TA) is a large vessel vasculitis that affects predominantly the aorta and its main branches.though it presents with limb claudication it can present with vasculitis involving internal organs with deleterious effects in heart .it is a CD4 T Helper cell mediated type IV hypersensitivity reaction leading to vascular inflammation . Interleukin–6 is one of the key cytokines. Steroids remain the cornerstone of therapeutic management.although mycophenolate mofetil,methotrexate and azathioprine are commonly used for maintenance drugs, Tocilizumab may be an effective, steroid–sparing agent for rapid control of disease activity in patients with life threatening indications. Recently reported multicenter studies, demonstrated the benefit of Tocilizumab in TA, for events free survival. OBJECTIVES: To assess the clinical profile and the efficacy of Tocilizumab in patients with Takayasu arteritis. METHODS: This is a prospective observational study was conducted over 6 months at Institute of Rheumatology, Madras medical college, Chennai. 30 patients with active disease (ITAS>1) presenting first time/follow up to the clinic are given 6 monthly infusions of Tocilizumab (8mg/kg i.v). Pregnant women, lactating women, those with active TB/HIV, renal failure were excluded. Baseline clinical characteristics, acute phase reactants, findings of CT angiogram were recorded. Steroid dose, ITAS 2010, ESRwere assessed on admission, 3rd and 6th month of Tocilizumab therapy. RESULTS: Mean age, median disease duration and mean ITAS 2010 are 32±9.2 years, 9 months, and 13.3 ±4.3 respectively. Clinical presentation included Limb claudication (60%), Hypertension (47%), Constitutional (fever/weight loss) (20%), Stroke (13%), Cardiomyopathy (13%), Aortic regurgitation (13%), myocardial infarction (7%) and Carotidynia (3%). Type V (30%) is the predominant type seen in angiography. Mean Starting dose of steroids were 45.8±9.7mg and the dose is effectively reduced to 7.58±2.9mg at the end of 6 months of therapy. An ITAS score of 0 were seen in 90%, 100% of patients at the end of 3rd and 6th month of Tocilizumab infusion. All patients achieved a reduction in ESR at 3 months. CONCLUSION: Tocilizumab may be an effective steroid–sparing option for rapid control of disease activity in TA. However, relapse free survival after the cessation of Tocilizumab needs to be studied.