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Microscopic hematuria is common manifestation in patients with mild rheumatoid arthritis (RA). It has not been extensively addressed, to our knowledge, by scholars. In this review, we discussed in detail the epidemiological aspect of this problem from the clinical point of view. We reviewed many articles from different electronic databases on the web such as PubMed, LILACS, CINAHL, and PSYCH INFO to get up with a narrative review. Twenty-eight studies entailed the issue regarding etiology, pathology, clinical picture, prognosis complications, and treatment. This clinical sign must be addressed by clinical staff treating patients with RA. Also, further studies should be done to discover the hidden areas in this topic.