OBJECTIVES This study aimed to investigate and compare the gastrointestinal(GI) risk factors and treatment patterns of rheumatoid arthritis(RA) and osteoarthritis(OA) patients in real clinical practice of Korea. METHODS This was a nationwide, cross-sectional study of patients taking non-steroidal anti-inflammatory drugs(NSAID, either non-selective or selective COX-2 inhibitor(COX2i)) from 20 hospitals between December 2012 and September 2013. Total 1,896 patients who were ≥20 years old(RA:981 OA:915) and were taking NSAID at least 1 month were enrolled. Data were collected through medical chart review and patients survey. The GI risk factors included NSAID duration(≥3 months), high-dose of NSIAD use, drinking, smoking, comorbid disease, aspirin use, anticoagulant(warfarin) use, steroid use, Helicobacter pylori infection, experience of GI event(i.e. GI bleeding or ulcer). The treatment patterns were identified as non-selective NSAID(ns-NSAID) or COX2i with/without gastroprotective agents respectively. RESULTS In RA, proportion of patients taking NSAID≥3 months, smoker and steroid users were higher than in OA patients(p<.0001). In OA, proportion of patients who have comorbid disease and take aspirin were higher than in RA patients(p<.0001). The rest of the GI risk factors were present as a similar proportion in both groups. The percentage of treatment with COX2i (RA:54.3% vs OA:44.2%, p<.001) and gastroprotective agents (RA:83.0% vs OA:78.3%, p=.009) in RA patients was higher than that in OA patients. In older aged patients(age≥60) in both groups, there was tendency to get more treatment of COX2i(RA: 60.9%, OA:50.2%) compared to ns-NSAID. Interestingly, as patients get more numbers of GI risk factors, there seemed to get more proportions of ns-NSAIDs users in both RA and OA patients. CONCLUSIONS The proportion of GI risk factors found in OA patients was comparable to that in RA patients. There was a tendency to show preferential ns-NSAID treatment pattern rather than COX2i especially in the presence of multiple GI risk factors in arthritis patients.