Background: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by articular and extra-articular involvement. The extra-articular involvement in RA is primarily manifested in pulmonary system characterized with pleurisy, airway diseases, nodular formations, and interstitial involvement. Aim: The aim was to assess the need of pulmonary screening in RA. Patients and Methods: A cross-sectional observational study was conducted on 122 patients who presented with respiratory difficulties and suspected RA. Initial screening for pulmonary involvement was done with physical assessment and pulmonary function tests (PFTs) followed with high-resolution computerized tomography (HRCT) scan. Health-related quality of life was assessed with pre–post 6-min walk test (6MWT) followed with dyspnea assessment and pulse oximetry. Results: Of the 122 patients screened, 33 were diagnosed with RA. The mean age was 40–50 years, was more common in women, and PFT showed both restrictive and obstructive pattern. Review of HRCT pattern of all patients showed nonspecific interstitial pneumonia pattern as the most common finding. Patients had desaturation after 6MWT and worsening of dyspnea. Conclusion: The degree of pulmonary involvement in RA is related to the duration of the disease. Clinical assessment, PFT, and 6MWT used in combination are cost-effective tools in early detection. HRCT provides a better understanding of the pattern of pulmonary involvement in RA.