This study examined the types of social comparisons made by individuals with rheumatoid arthritis (RA) and the role these comparisons play in illness adjustment. Seventy-five women with RA were interviewed. The interview included measures of social comparison preferences assessed within two different contexts: the establishment of standards for desired performance and the experience of performance difficulties. Perceived ability, satisfaction with ability, and psychological adjustment also were assessed. We found that when respondents were experiencing performance difficulties they compared more frequently with other RA patients than with individuals not affected by RA. However, when establishing standards for desired performance, the latter type of comparison was more common. Further, respondents' comparison preferences were not related to perceptions of ability, but were related to satisfaction with ability. Greater satisfaction was associated with comparison with individuals not affected by RA when establishing standards for desired performance and comparison with other RA patients when experiencing performance difficulties. Satisfaction, in turn, was positively related to psychological adjustment.