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BACKGROUND: Rheumatoid arthritis is a devastating condition. Moreso, the diagnosis of seronegative rheumatoid arthritis is often fraught offwith much uncertainty and that leads to further suffering to theunfortunate patient.CASE DETAILS: This is a case of Madam A, who presented with manynon-specific symptoms and signs involving many systems which wasfinally diagnosed as seronegative rheumatoid arthritis. This case exploresthe challenges in reaching this uncommon diagnosis and how anti-inflammatory drugs can bring a miraculous relief to the patient’ssuffering.CONCLUSION: The diagnosis of seronegative rheumatoid arthritis oftenpresents a real challenge to the medical practitioner and often requiresmultiple visits and/or shared multidisciplinary care for confirmation ofthe diagnosis. Once diagnosed and treated with disease modifying anti-rheumatic drugs, often there is a miraculous relief to the patient’ssuffering.