Rheumatoid arthritis is a chronic autoimmune inflammatory arthritis. It is the most common inflammatory arthritis affecting worldwide. Nearly 1 % of the world is affected with this debilitating disease. We are reporting one such case of rheumatoid arthritis with classical skeletal manifestations. A 65 year old man presented with history of progressive breathlessness and pain on the left side of the chest. He also had swelling and pain of the joints of hand, foot and knee on both sides since last 12 years. He also had developed deformities of hands and toes. On Examination left sided mild to moderate pleural effusion was diagnosed and diagnostic aspiration showed rheumatoid etiology. Classical deformities of hand are shown in this case report.