In Latin America countries, many patients with rheumatoid arthritis (RA) have unmet treatment needs. One reason is the sparse number of rheumatologists available to population, which causes that patients have difficulty to achieve adequate care. It usually leads patients to not receive antirheumatic drugs opportunely and probably to have limited access to rehabilitation or education programs affecting them in everyday driving and adjustment of illness. The national health care systems within Latin America are very dissimilar in their organizational structure, different in their operational configuration, and in majority of cases the principles guiding the public and private sector roles in the provision of health care services in every country are even divergent. The REAL-PANLAR project originate from the strategic need for the implementation of Centers of Excellence (CoE) in rheumatoid arthritis in Latin America in which, under the coordination of a rheumatologist, a comprehensive management of patients with this pathology is established,  ensuring approachability to medical appointments and treatment, and in order to get better clinical outcomes and improve patient safety; on the other hand, the idea is also achieve multiple and various data for research and to improve national and regional policies regarding this disease. A Rand modified Delphi procedure of five steps was applied to define categories of centers of excellence; twenty-two opinion leaders from member countries of PANLAR, two patients and two quality experts participated in definition of minimum quality standards, and of three types of centers of excellence: STANDARD, OPTIMUM AND MODEL; each type of facility must meet a minimum in indicators of structure, processes and outcomes. This is the first Latin American countries effort to improve patient accessibility to rheumatologists and medications, and to standardize the quality of treatment provided to RA patients through establishing centers of excellence.