Rheumatic and immune diseases commonly affect more than 0.5% of the general population. In recent years, the treatment remedies for rheumatic and immune diseases evolve rapidly. Based on our knowledge about the dysregulation of immune responses in the pathogenesis of rheumatic and immune diseases, immune-based biological agents have been developed and in fact have revolutionized the management and control of many rheumatic and immune diseases. TNF-α-blocking agents are the foremostbiological agents used to successfully treat rheumatoid arthritis (RA). Other biological agents, including abatacept,and Tocilizumab,andrituximab,then follow the pathof virtueadding the gloryof RA treatment. Recently,small molecules, such as tofacitinib, that cytokine signalingalso showed good efficacy in the RA treatment. The use of the existed biological agents and small molecules may be applied to the treatment of different rheumaticand immunediseases, and new biological agents and small molecules are alsoemergingto join the treatment ofdifferentrheumatic and diseases. molecules that target different components of immune responses and may be comingto treat RA in the futureIn this talk, the pathogenesis of different rheumatic and immune diseases will be discussed. Biological agentsand small moleculeswill be reviewed for their clinical applicationsin the treatment of different rheumatic and immune diseases, such as RA, psoriasis, psoriatic arthritis, ankylosing spondylitisand inflammatory bowel diseases. The safety concerns about different biological agentsand small moleculeswill also be reviewed. After the talk, you should have a better understanding about the pathogenesis of severalrheumatic and immune diseasesand about the mechanisms, efficacy and safety of different biological agentsandsmall molecules.