© 2015 ElsevierInc. Juvenile idiopathic arthritis (JIA) is a leading cause of acquired disability and malformation in childhood. Although virtually any joint can be affected, one of the most commonly involved yet least frequently recognized joints is the temporomandibular joint (TMJ).1 Persistent arthritis can result in pain, growth problems, cosmetic defects, and poor function, underscoring the necessity of obtaining early control of TMJ arthritis. While the therapy of JIA as a whole has benefitted enormously from the introduction of novel therapeutic agents,2 it remains uncertain to what extent these therapies benefit the TMJ specifically. Thus, many practitioners use intra-articular therapy for refractory TMJ arthritis, although concerns about their long-term safety have been raised.3 Herein, we will review the data on systemic and local anti-inflammatory therapy of TMJ arthritis.