OBJECTIVES: We conducted a systematic review to appraise the methodological quality of controlled clinical trials evaluating the efficacy and safety of Chinese herbal medicine (CHM) patients with rheumatoid arthritis (RA). METHODS: We searched electronic databases (Medline, EMBASE, The Cochrane Library, and Web of Science) from inception until May 2014. Study selection was performed by 2 independent reviewers. The methodological quality of the trials was assessed using the Cochrane risk of bias tool for randomized trials and Newcastle Ottawa Scale for controlled non-randomized studies.  RESULTS: CONCLUSIONS: Studies evaluating CHM often fail to meet expected methodological criteria, and high quality evidence is lacking. Future studies of CHM should be methodologically robust and adhere to reporting guidelines such as the CONSORT statement for TCM.