The aim of the study was verification of some factors deemed to be predictive of inflammation and instability of upper cervical spine in rheumatoid arthritis. 100 patients (88 female and 12 male) aged 23 to 85 (61.4±12.9), with the mean disease duration of 12.5±9.5 years were included in the study. According to radiological examination (lateral and antero-posterior X-ray of the cervical spine) supplemented by MR of the cervical spine or CT of the atlanto-axial joint in suspected cases, 25% of patients had only inflammation, next 14% of patients presented with instability of the atlanto-axial joint and 9% developed basilar invagination of the dens of axis; 18% of patients presented subaxial cervical instability. Patients with cervical instability were consulted by neurosurgeon. Six of them (5 with atlanto-axial subluxation and 1 with basilar invagination) were qualified to surgical stabilization of the cervical spine. Statistically significant correlation between the number of hand joints with erosions and Carpal Height Ratio was found. Disease duration, age of disease onset, presence of rheumatoid nodules and rheumatoid factor, indicators DAS 28 and HAQ, as well as use of corticosteroids did not correlate significantly with the incidence of inflammatory changes of the atlanto-axial joint.