Aim <p>This study aimed to compare talar cartilage thickness in patients with RA and healthy controls and to investigate its association with clinical and demographic variables.</p> Method <p>Thirty-seven healthy controls and 63 patients with RA diagnosed using the American College of Rheumatology’s (ACR) 2010 criteria were included in this cross-sectional observational study. All participants’ age, gender, and body mass index (BMI) were recorded. The hospital record system’s data was retrieved for the patient group, including medication use, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), seropositivity, and disease duration. VAS was used to assess pain, and DAS-28 was used to assess disease activity. Talar cartilage thickness measurement was performed by the same doctor as the ultrasound. Descriptive statistics of the data obtained from the study were given by mean, standard deviation for numerical variables, and frequency and percentage analysis for categorical variables. Mann–Whitney <i>U</i> test was used for categorical variables with two groups, and Kruskal Wallis test was used for categorical variables with three or more groups in the comparison of parameters according to categorical variables. Analyses were performed with the help of SPSS 22.0 program. <i>p</i> &lt; 0.05 significance level was selected.</p> Results <p>There was no discernible difference between the patient and control groups in terms of age, height, weight, gender, or BMI values (<i>p</i> &gt; 0.05). Talar cartilage thickness did not significantly correlate with age, BMI, ESR, CRP, CCP, DAS-28 RF, number of swollen joints, or sensitive joints (<i>p</i> &gt; 0,05). However, talar cartilage thickness, VAS, HAQ values, and disease duration were significantly correlated negatively (<i>p</i> &lt; 0.05).</p> Conclusion <p> Our study showed that there is a significant decrease in talar cartilage thickness in RA patients, and this decrease is associated with disease duration, pain severity, and functional impairment.</p> <p><Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry align="left" nameend="c2" namest="c1"> <p><b>Key Points</b></p> <p>• <i>Talar cartilage thickness was found to be lower in RA patients compared to the control group</i></p> <p>• <i>Talar cartilage measurements were negatively correlated with disease duration, VAS and HAQ scores</i></p> <p>• <i>Talar cartilage thickness may be a potential biomarker for assessing early joint damage and monitoring disease progression in RA</i></p> </entry> </row> </tbody> </tgroup> </Table></p>