Objective: This study aims to assess left ventricular diastolic functions with tissue Doppler imaging (TDI), which is a new technique, and to compare it with conventional Doppler echocardiography techniques in patients with active rheumatoid arthritis (RA). Methods: Fifty-two patients with active RA and 47 healthy persons were included in this study. All patients and the control group were evaluated by M-mod, two-dimensional, conventional Doppler echocardiography and TDI. Results: Left ventricular early diastolic (E)/late diastolic (A) flow velocity (E/A ratio) was found to be lower in patients with RA than in the control group (p < 0.001). Mitral annular early diastolic (E-m)/late diastolic (A(m)) velocity(E-m/A(m) ratio) was found to decrease in RA patients compared with the control group (p < 0.001). E/E-m ratio was higher in patients with RA than in the control group (p < 0.001). Conclusion: Left ventricular diastolic functions were impaired in patients with RA. We have concluded that TDI alone, or together with conventional Doppler echocardiography, is useful for the evaluation of diastolic functions in RA patients.