The purpose of this study was to conduct a systematic review to examine evidence for the use of herbal medicines for rheumatoid arthritis based on RCTs. Computerised searches of eight electronic databases and the bibliographies of identified articles resulted in 14 studies meeting the inclusion criteria. Two raters independently extracted data and rated the trials for quality. There is moderate support for γ-linolenic acid, which is found in some herbal medicines, for reducing pain, tender joint count and stiffness. For other herbal medicines there was only a single RCT available, resulting in weak evidence. In general, herbal preparations were relatively safe to use.