Rheumatoid arthritis and periodontitis use analogous effector destructive procedures, in that the inflammatory cells and pro-inflammatory cytokines that drive chronic bone erosion in RA and chronic periodontal destruction in Periodontitis are alike. Periodontitis (PD) has appeared as a hazard factor in a number of health situations as rheumatoid arthritis (RA). To determine the effect of anti-tumor necrosis factor alpha biological treatment (methotrexate and Enbrel or infliximab) on periodontal status of patients having rheumatoid arthritis with periodontitis in comparison to those having periodontitis without rheumatoid arthritis and control healthy subjects and to determine the serum levels of anti-cyclic citrullinated peptide (ACCP) in these groups. Periodontal parameters used in this study were plaque index (PI), gingival index (GI), bleeding on probing (BOP) and clinical attachment level (CAL). Serum levels of anti-cyclic citrullinated peptide (ACCP) was estimated by enzyme linked immunosorbent assays (ELISA). The Blood samples were gathered from 75 patients (25 patients had rheumatoid arthritis with periodontitis, 30 patients with periodontitis only and 20 evidently healthy volunteers). The current data revealed that the median value of plaque and gingival indices were higher in the periodontitis group than in rheumatoid arthritis with periodontitis group while CAL was slightly higher in rheumatoid arthritis with periodontitis group than periodontitis group. The percentage of BOP sites were higher in periodontitis group than rheumatoid arthritis with periodontitis. The serum level of anti-cyclic citrullinated peptide was found to be higher in the periodontitis group (601.846) followed by rheumatoid arthritis with periodontitis, which had the lowest median (163.99), while the median value of ACCP in control group was (218.617), and the result was statistically non-significant difference between the study groups p> 0.05. There was no correlation between anticyclic citrullinated peptide and clinical periodontal parameters in each group except in gingival index, bleeding on probing of the periodontitis group as there was significant correlation. Patients with RA receiving biological treatment had lower anti_cyclic citrullinated peptide antibody and lower periodontal indices when compared with the other patient that not taking biological therapy. Thus, suppression of pro-inflammatory cytokines might have a beneficial effect in reducing inflammatory activity in rheumatoid arthritis disease and in minimizing the periodontal destruction of chronic periodontitis.