Objectives: To assess treatment satisfaction among RA patients and determine factors affecting it; aiming at improving the clinical disease outcome. Methods: A cross-sectional study included 316 Egyptian patients. Patients were subjected to full history, complete clinical examination (general and articular) including assessment of disease activity using (CDAI) & (DAS 28) scores, and routine laboratory investigations. Patients were also subjected to assessment for presence of fibromyalgia using 2016 ACR criteria, assessment of treatment satisfaction using Treatment Satisfaction Questionnaire (TSQM), assessment of functional outcome using the Rheumatoid Arthritis Impact of Disease (RAID) score, assessment of Health-Related Quality of Life HRQoL using Modified Health Assessment Questionnaire (MHAQ) and assessment of medication compliance using (MORISKY) score. Results: 49 (15.6%) patients were satisfied, and non-satisfied group was 267 (84.4.%) patients. The final multivariate model included only RAID score and CDAI score as significant predictors of non-satisfaction .Most of our patients (48.1%) showed medium compliance to treatment. Conclusion: The prevalence of burdensome symptoms and adverse impacts on health-related HRQoL observed in this study suggests that there is unmet need for many patients despite the currently available treatment options, even among those patients who are satisfied with their RA treatment and even among patients who are in clinical remission. Key messages Patients reported outcome should be Implemented to asses and deal with unmet needs of RA patients. Patient perspective should be included during treatment plan and during appropriate treatment switching and escalation.