Albaqami J, et al. - The researchers recruited fluent Arabic translators for forward and backward translation of the methotrexate (MTX, an anchor drug for the treatment of rheumatoid arthritis {RA}) intolerance severity score (MISS) in order to verify the MISS in the Arabic language. One hundred and eighty-five patients were recruited (female=158). A total of 30% of the patients (n=55) were illiterate. A positive MISS was observed in 39.5% of the patients (n=73). The use of the oral and subcutaneous forms of MTX was seen in 75.3% (n=55) and 24.7% (n=18) of the patients, respectively. For test-retest and factor analysis, the Arabic MISS had excellent internal consistency and factorable study size. Hence, in recognizing MTX intolerance in RA patients, validity and good reliability was exhibited by the Arabic MISS. The prevalence of MTX intolerance among RA patients was also noted. To confirm these findings, more extensive studies are required.