RA is a chronic, inflammatory, autoimmune disease with an unclear etiology, primarily manifested by inflammation, deformity, and loss of function in the small joints of hands and feet [1,2]. The pathological features of RA include synovitis, vasculitis, osteoarticular destruction and the formation of rheumatoid nodules [3,4], and it may also involve other tissues and organs, including the eyes, nerves, skin, kidneys, lungs, liver, heart and bones in severe cases [5]. The pathogenesis of RA is complex, mainly involving genetics, environment, and abnormalities in immune cell and signaling networks [1,6]. The majority of RA patients are female, with a male-to-female ratio of 1:3 [7,8]. Women, aged 35 to 50, are more likely to develop RA [9], possibly due to the role of estrogen in the occurrence and development of RA. Accumulating evidence suggests that there are alterations in metal homeostasis in the serum of patients with RA [10,11]. Studies have confirmed that the Cu/Zn ratio may contribute to the diagnosis and prognosis of RA and is also a marker of changes in the antioxidant defense system in patients with RA [12]. A meta-analysis of 102 RA patients and 66 healthy controls showed significantly elevated the concentrations of circulating levels of copper in RA patients, which were positively correlated with DAS28-CRP and inflammatory markers [13]. Excessive "free" copper acts as a potent pro-oxidant, driving oxidative stress, cartilage/bone destruction, inflammatory responses, and pannus formation. However, copper also plays crucial physiological roles in antioxidant defense, angiogenesis, and bone maintenance. Additionally, copper bound to ceruloplasmin has anti-inflammatory effects. Therefore, Clarifying the double-edged role of copper in RA makes it particularly urgent to explore therapeutic strategies for maintaining copper homeostasis. In this paper, we review the research progress of copper in RA, especially the contradictory effects of copper on RA under physiological and pathological conditions, and discuss the future research directions and challenges, providing new ideas for the study of copper-related mechanisms and targeted therapy.