Objective. The aim of the study was to evaluate the effect of subcutaneous form of methotrexate (metoject - MTJ) on the structural and functional characteristics of the vascular wall in patients with rheumatoid arthritis (RA).\nMaterials and Methods. 94 patients with RA corresponding to ACR (1987) or ACR/EULAR (2010) classification criteria, positive for IgM rheumatoid factor (RF) and/or antibodies to cyclic citrullinated peptide (ACCP) were selected. Visualization of the carotid arteries with the definition of the local rigidity of the vascular wall, as well as the study of regional arterial stiffness, including an evaluation of the contour analysis of the pulse wave, were performed before treatment and after 12 months of therapy.\nResults. It was established that patients with RA had subclinical damage of main arteries, showing the increase in the intima-media thickness (IMT) and stiffness index of the common carotid artery, indices of augmentation (AIp), stiffness (SI) and reflection (RI), the values of which correlated with the duration of RA, DAS28 activity index, RF level and ACCP concentration. The use of MTJ in patients with RA was accompanied by a statistically significant decrease in DAS28, reduction of carotid IMT and local (carotid) rigidity of the vascular bed. More significant changes were identified in the group of RA patients with disease duration of up to 2 years, in whom the regression of IMT was 29% (p<0.01), and stiffness index of the common carotid artery on average decreased by 22.5% (p<0.05) to the end of follow-up. According to the contour analysis of the pulse wave, after 12 months of treatment with MTJ decrease of AIp, SI and RI indices was observed in patients with RA, mostly in the group with RA duration of up to 2 years - in this group the mentioned parameters reached the values of the control group; in late RA those parameters decreased in average in 1.7 times (p<0.01), 1.3 times (p<0.01) and 1.8 times (p<0.05), respectively. \nConclusion. MTJ therapy, along with high anti-inflammatory activity, demonstrates vasoprotective effect, which is characterized by the reduction of signs of remodeling of the common carotid artery and regional arterial stiffness.