Background: Early aggressive treatment in rheumatoid arthritis (RA) reduces joint damage and improves function. The introduction of serum antibodies against citrulline-containing molecules showed some promise as diagnostic tools in RA. Aim of the study: The aim of this study was to determine the performance of antibodies against mutated citrullinated vimentin (anti-MCV) in comparison with antibodies to cyclic citrullinated peptides (anti-CCP) in patients with rheumatoid arthritis (RA). Subjects and methods: Anti-CCP and Anti-MCV levels were measured in 44 subjects. They were 24 recent onset rheumatoid arthritis with disease duration not more than one year, and 20 apparently healthy volunteers as a control group. Disease activity was measured using the disease activity score (Disease Activity Score based on 28 joints [DAS28]). Parameters of disease severity evaluated by disease duration, RF titer and x ray finding. Results: The difference in anti-MCV and anti CCP levels between RA patients and healthy controls was highly significant. All parameters of disease activity were correlated with these antibodies except number of swollen joints was insignificantly correlated with anti-CCP antibodies. There was highly significant correlation between Anti-MCV antibody and radiographic scoring of hand and wrist. The sensitivity and the specificity of anti-MCV were 75% and 95%, respectively. The sensitivity and the specificity of anti-CCP were 66.6% and 90%, respectively. Conclusion: Anti-MCV showed higher sensitivity and specificity more than anti-CCP , also appeared to perform better than anti-CCP in identifying poor radiographic prognosis in patients with early RA.. These antibodies appear to be very useful in the diagnosis of recent onset RA.. Follow up of clinical and laboratory data, to evaluate the prognostic significance of anti-MCV and anti-CCP in RA and their relation to treatment efficacy is recommended