Objective. To study the long-term effects of supplementation with omega-3 fatty acids (ω3) in patients with active rheumatoid arthritis. Methods. Ninety patients were enrolled in a 12-month, double-blind, randomized study comparing daily supplementations with either 2.6 gm of ω3, or 1.3 gm of ω3 + 3 gm of olive oil, or 6 gm of olive oil. Results. Significant improvement in the patient's global evaluation and in the physician's assessment of pain was observed only in those taking 2.6 gm/day of ω3. The proportions of patients who improved and of those who were able to reduce their concomitant antirheumatic medications were significantly greater with 2.6 gm/day of ω3. Conclusion. Daily supplementation with 2.6 gm of ω3 results in significant clinical benefit and may reduce the need for concomitant antirheumatic medication.