OBJECTIVE： To observe the clinical efficacy and safety of [99Tc]MDP injection combined with disease-modifying anti-rheumatic drugs （DMARDs） in the treatment of advanced rheumatoid arthritis （RA）. METHODS： 106 patients diagnosed as RA were divided into treatment group and control group according to random number table， with 53 cases in each group. Control group was only given DMARDs and non-steroidal anti-inflammatory drugs （NSAIDs）. Treatment group was additionally given [99Tc]MDP injection （A injection 5 mL containing 0.05 μg [99Tc]MDP； B injection containing MDP 5 mg， stannous chloride 0.5 mg） on the basis of control group； 3 A injections and 3 B injections were mixed and shaken well， and then added into 0.9％ Sodium chloride injection 100 mL after placing for 5 min， ivgtt， qd. A treatment course lasted for 10 d， and both groups received 3 courses of treatment. Clinical efficacies of 2 groups were observed as well as morning stiffness time， the number of swollen joint and tender joint， erythrocyte sedimentation rate （ESR）， rheumatoid factor （RF）， anti cyclic citrullinated peptide antibody （CCP）， CRP， disease activity score （DAS28） and T values of lumbar bone mineral density before and after treatment. The time of sign improvement and the occurrence of ADR were compared between 2 groups. RESULTS： In the treatment group， 1 cases were dropped off， 52 cases completed the study， 3 cases of the control group were dropped off， 50 cases completed the study. The total effective rate was 94.2％ in treatment group， which was significantly higher than 80.0％ of control group， with statistical significance （P＜0.05）. Before treatment， there was no statistical significance in morning stiffness time， the number of swollen joint and tender joint， ESR， RF， CCP， CRP， DAS28， T values of lumbar bone mineral density between 2 groups （P＞0.05）； after treatment， above signs and lab indexes of 2 groups were improved significantly， and the treatment group was significantly better than the control group， with statistical significance （P＜0.05）. The time of sign improvement in treatment group was significantly shorter than in control group， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： [99Tc]MDP injection combined with DMARDs is effective for advanced RA， and can relieve sign rapidly and improve lab indexes with good safety.