Background: Hyperuricemia is a common risk factor for conditions associated with oxidative stress. Alternatively, there is increasing evidence that normal serum uric acid (UA) plays a protective role as an antioxidant. Osteoporosis was commonly attributed to oxidative stress and is a common complication of rheumatoid arthritis (RA). Objectives: To study the relationship between serum UA and bone mineral density in male patients with rheumatoid arthritis. Patients and methods: Fifty RA male patients were included in this study. Age, disease duration, and type of medication were recorded. Clinical examination for tender and swollen joints was done and disease activity score 28 was calculated. Body mass index, random blood glucose, erythrocyte sedimentation rate, C-reactive protein, serum UA, rheumatoid factor and anti-CCP were measured. Bone mineral density was measured using dual-energy X-ray absorptiometry at the lumbar spine, hip and radius. Results: A highly significant positive correlation between serum UA and T scores in the lumbar spine and hip. However, serum UA was negatively correlated with disease activity, ESR and CRP (P < 0.001). There was significant (P < 0.001) association between serum UA and different therapeutic agents (levels of serum UA were higher in patients taking combined biological and conventional disease modifying anti-rheumatic drugs (DMARDs) than those who were taking biological or conventional DMARDs alone. Conclusion: High normal serum UA level is protective against osteoporosis at both the lumbar spine and hip in male rheumatoid arthritis patients. Also, serum UA level is negatively correlated with RA disease activity and acute phase reactants in male patients with RA.