OBJECTIVES:   Published evidence on the prevalence of non-steroidal anti-inflammatory drug (NSAID) and gastroprotective agent (GPA) use in the United States (US) is lacking. We examined the prevalence of GPA use among arthritis patients using NSAIDs. METHODS:   A web-based community panel of men and women age ≥40 in the United States with self-reported arthritis was invited via e-mail to participate in a web-based survey.  Panelists interested in participating provided consent and completed the survey.  Only participants who reported using an NSAID in the last 30 days were eligible.  Questions regarding NSAID and GPA use (medication/dosage/frequency/duration of use) were asked, as were comorbid conditions, gastrointestinal history, and other risk factors. RESULTS:  Two thousand met the inclusion criteria and completed the survey (54% response rate). The majority of participants had osteoarthritis (n=1525, 76%), 354 (18%) had rheumatoid arthritis, and 121 (6%) had both.  Mean age was 62.0 years; 64% were female; 83% were Caucasian; 25% worked full-time and 39% were retired.  The majority (92%) had health insurance, with half covered by Medicare/Medicaid.  Mean time with arthritis was 13.0 years; 47% and 19% experienced arthritis symptoms “daily” and “almost always”, respectively.  The most frequently-used NSAIDs were ibuprofen (54%), aspirin (35%) and naproxen (33%).  Nearly 43% reported using a GPA with 86% (n=731) reporting use more often than three times per month.  The most frequently-used GPAs were omeprazole (48%), ranitidine (17%) and esomeprazole (17%).  Of daily NSAID users, 42% reported taking a GPA.  Of non-GPA users, 12% reported a history of gastroesophageal reflux disease, 9% reported a history of ulcers, and 3% reported a history of gastrointestinal bleeding. CONCLUSIONS: This is the first study in the United States to document NSAID and GPA use. Importantly, only 42% of daily NSAID users take GPAs on a routine basis, leaving the majority of NSAID users at risk for gastrointestinal complications.