Objective To evaluate the clinical efficacy of needle warming moxibustion in the treatment of rheumatoid arthritis， and their regulatory effect on IL-6 and TNF-a. Methods 60 patients with rheumatoid arthritis were randomly divided into acupuncture group and drug group. The treatment period was 4 week. Tender joint count， handgrip strength， morning stiffness time， the quality of life（HAQ） scores before， the end of the first（1-2 week after treatment） and second（3-4 week after treatment） course were evaluated. IL-6 and TNF-a levels before and after treatment were measured. Results Both groups had significant improvement of rheumatoid arthritis int the ender joint count， handgrip strength， morning stiffness time， the quality of life（P<0.01）. The total effective rates of the acupuncture group and drug group were 80% and 73.3%， respectively， which showed no significant difference between the groups（P>0.05）. The acupuncture group had better efficacy than acupuncture group at the end of the first course（P<0.05）. SIL-6 and TNF-a levels decreased in both group after treatment（P<0.01）. Conclusion Both needle warming moxibustion and methotrexate have good results for rheumatoid arthritis， and acupuncture treatment may shorten the course of treatment. The mechanism of needle warming moxibustionfor rheumatoid arthritis may be through regulating IL-6 and TNF-a.