OBJECTIVES: Patients with chronic inflammatory disorders, such as rheumatoid arthritis (RA) or spondyloarthritis (SpA), have personal sets of fears and beliefs related to their disease that may influence the patient-physician relationship and treatment adherence. The objective was to describe the most frequent fears and beliefs in RA and SpA patients.  METHODS: Cross-sectional assessment of unselected patients with a diagnosis of RA (ACR/EULAR criteria) or axial SpA (axSpA)(ASAS criteria) in France in 2014. The study was proposed to all rheumatologists in France. A self-reported 44-item questionnaire (25 items on fears, 19 on beliefs) was built and preliminarily validated for this study. Each item was scored 0–10 (10 indicating higher fears/stronger beliefs). The analysis was descriptive for the 5 fears and 5 beliefs most frequently scored as ≥7/10, in both axSpA and RA patients. RESULTS: Overall, 226 patients (161 RA, 65 axSpA; 64.4% female) were analyzed: mean disease duration 11.9 vs 13.8 years and mean patient’s global assessment 31/100 vs 41/100 for RA vs axSpA patients, respectively. Of the 25 listed fears, the 6 most frequently reported were: “afraid of suffering again” (66.7% scored this as ≥7/10), “afraid of losing control and autonomy” (61.4%), “afraid of being a burden for relatives” (59.6%), “afraid of losing all joint mobility” (58.9%), “afraid of the spread of the disease to other joints” (58.6%) and “afraid of the consequences of my disease on my professional activity” (58.6%). Of the 19 listed beliefs, the 5 most frequently reported were: “flares are triggered by fatigue” (41.7%), “physical activity reduces flares” (38.7%), “flares are triggered by changes in the weather” (37.3%), “flares are triggered by physical effort” (37.1%) and “the disease is linked to a genetic cause” (36.9%). CONCLUSIONS: This study highlights the main fears and beliefs from a patient perspective using a novel questionnaire specific to chronic inflammatory arthritis.