Objective: to evaluate the influence of chronic inflammatory state on endothelial function in patients with Rheumatoid Arthritis by measuring endothelial reactivity in young patients with RA with low disease activity and without traditional cardiovascular risk factors.Methods: Brachial flow mediated vasodilatation (FMV), assessed by non-invasive ultrasound, was evaluated in 30 young to middle aged patients with RA (age ≤ 45 years), with DAS28 ≤3.2 and without overt cardiovascular disease, and in 15 age and sex matched healthy controls.Results: Mean (SD) FMV was significantly lower in patients than in controls (3.5 ± 0.5 vs. 5.6 ± 0.1 ℅ ;p< 0.001), also significantly lower basal brachial artery diameter, basal brachial artery flow and post-hyperemic flow. FMV inversely related to low density lipoprotein cholesterol (r =-0.51, p < 0.05), basal brachial artery diameter (r = -0.43, p < 0.05), Mean (SD) of CCA IMT was significantly higher in patients than in controls (0.7±0.1 vs. 0.3 ± 0.1℅; p< 0.001). Conclusion: An altered endothelial reactivity is detected in young to middle aged patients with RA with low disease activity, free from cardiovascular risk factors and overt cardiovascular disease, it seems to be primarily related to the disease associated chronic inflammatory condition.