During the last 50 years the number of overweight and obese people in developed countries has increased dramatically. The consequences of this excessive fat accumulation have been associated with a multitude of co- morbidities, mainly related to the cardiovascular system and glucose and lipid metabolism. However, obesity also has an impact on other diseases, as an enhancer of certain pathological aspects or as a susceptibility factor, including certain rheumatic diseases such as rheumatoid arthritis (RA), osteoarthritis (OA) and systemic lupus erythematosus (SLE). The link between obesity and these rheumatic diseases has been purported to be via the action of metabolic factors produced by adipose tissue, adipokines. Among these adipokines are leptin and adiponectin, which have been extensively studied. Our knowledge of the role of other relevant newer adipokines, such as visfatin, in the arthritides is rapidly growing. Therefore, in this review our aim is to summarize the current literature regarding the association between visfatin and the most relevant rheumatic diseases.