Rheumatoid arthritis (RA) patients experience higher mortality from cardiovascular events, possibly as a result of systemic inflammation. The aim of this study was to investigate the effects of oral coenzyme Q10 (CoQ10) supplementation on cardiovascular disease (CVD) risk factors in these patients.45 RA patients with moderate and severe disease activity (DAS28>3.2), participated in this randomized controlled clinical trial. Participants were randomly assigned to CoQ10 or a placebo group. 22 of subjects took 100mg/day CoQ10 and the remainder took a placebo for 60 days (in addition to conventional medicine). Body weight, systolic and diastolic blood pressure, serum cholesterol, triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL) and C-reactive protein (CRP) were measured before and after intervention. Dietary intake was assessed twice using a three day food record.At the end of study baseline body weight and LDL in the CoQ10 group reduced significantly (−0.71kg and −8.58mg/dL, respectively; p<0.05). The placebo group showed a significant decrease in total cholesterol and LDL (−10.40 and −11.33mg/dL, respectively; p<0.05) and a significant increase in TG (+20.09mg/dL; p<0.05). CRP levels did not significantly decrease in CoQ10 and placebo groups (−5.17 vs. −2.97mg/L). No significant differences were seen between groups regarding body weight, blood pressure, lipid profile and CRP.60 days supplementation with 100mg/day CoQ10 showed some indication of a reduction in body weight and LDL but overall no meaningful improvement was seen in CVD risk factors. Studies with larger number of patients, longer follow up and higher doses of the supplement may provide evidence of effectiveness.