〔Abstract〕 Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by persistent synovial inflammation and progressive joint destruction. Recent studies have shown that lactate metabolic reprogramming plays a key role in the pathological process of RA, and the accumulation of lactate in the synovial microenvironment triggers a cascade of immune regulatory effects. These metabolic changes create a self-sustaining cycle of inflammation and tissue damage, leading to progressively worsening disease. Therefore, lactate metabolism has been identified as a therapeutic target. Therapeutic strategies targeting lactate metabolism, such as LDHA inhibitors, targeting PKM2, MCT inhibitors, GPR81 antagonists, and lactylation modification regulators, have shown great potential in restoring immune balance and protecting joint integrity. This review summarizes the mechanisms of lactate metabolism in RA and its therapeutic applications, providing a theoretical basis for the development of novel metabolic intervention therapies.