The aims of our study were to assess whether the increased oxidative stress in inflamed joints is reflected by serum lipid peroxidation and also to check alterations in the levels of extracellular antioxidants and antioxidant enzyme activities in patients with rheumatoid arthritis. Serum malondialdehyde and ceruloplasmin levels and the activity of CuZn superoxide dismutase were higher, while transferrin levels and the activities of glutathione peroxidase and catalase were lower in patients (n = 37) than in healthy controls (n = 30). Disease activity score correlated positively with serum malondialdehyde level and CuZn superoxide dismutase activity. Probably, superoxide radicals in serum could be dismutated to produce hydrogen peroxide by increased CuZn superoxide dismutase activity, but hydrogen peroxide could not have been detoxified due to decreased activities of serum glutathione peroxidase and catalase. Hydrogen peroxide possibly converted to hydroxyl radical by iron due to lower transferrin level might have led to increased serum lipid peroxidation in patients with rheumatoid arthritis.