The 66^th Annual Scientific Meeting of the American College of Rheumatology and 38th Annual Scientific Meeting of the Association of Rheumatology Health Professionals took place in San Antonio, Texas from October 17 to October 21, 2004. Over 2,000 abstracts were presented, along with a number of state-of-the-art lectures and topical symposia. Full abstract reports may be reviewed in the September edition of Arthritis & Rheumatism 47, no. 9 suppl., 2004. While it is not possible to review all of the important findings from these meetings, some selected highlights are summarized below. The majority of these highlights focus on clinical aspects of rheumatoid arthritis and osteoarthritis (consistent with the mission of this WebSite); however, limited reviews of meeting highlights relating to the systemic rheumatic diseases, including lupus, scleroderma, myositis, spondyloarthritis, and vasculitis, are also provided. Highlights are categorized according to disease.