Treatment of chronic arthritis in childhood is progressing quickly. Nonsteroidal antiinflammatory drugs still remain mainstays of treatment, but weekly methotrexate and intra-articular corticosteroid injections have made the biggest impact on disease control. Recently, tumor necrosis factor inhibitors have become available for the treatment of chronic childhood arthritis and have already had a substantial influence on disease activity. Very aggressive measures are still reserved for the sickest children who do not respond to conventional therapy, but the future for children with chronic arthritis looks bright with newer, highly targeted biologic therapies in the pipeline. © 2002 Lippincott Williams & Wilkins, Inc.