Background: Rheumatoid arthritis is a systemic autoimmune disease characterized by inflammatory polyarthritis. Prolactin acts as a potent immunomodulator and may play a role in disease severity and the process of joint damage in Rheumatoid arthritis. Aim of Study: The aim of this study was to evaluate the level of serum prolactin in patients with Rheumatoid arthritis and determine its association with disease activity and structural damage. Patients and Methods: The study included 40 patients with Rheumatoid arthritis and 20 healthy individuals as controls. All patients were subjected to clinical and immunological evaluation and assessment of disease activity using the DAS 28 score. Plain X-ray of both hands and feet were done for joint damage assessment by using SENS score. Results: Serum prolactin concentrations in patients were significantly higher (Mean±SD 11.9±7.30) than controls (Mean±SD 6.92±3.62) (P-value < 0.05). Higher level of serum prolactin was detected in patients with severe disease activity by DAS-28 score (Mean±SD =13.77±7.288) compared to patients with moderate (Mean±SD = 5.89±1.03) and low disease activity (Mean±SD = 4.25±0.35) (p-value = 0.008). Serum prolactin levels significantly correlated with DAS-28score (p-value =0.000). Conclusion: Serum prolactin increases in Rheumatoid arthritis patients and higher levels are associated with severe disease activity, however further studies with larger number of patients is still needed to establish the exact role of prolactin in the pathogenesis of Rheumatoid arthritis.