Purpose of the Review <p>Rheumatoid arthritis (RA) is a complex chronic autoimmune disease characterized by abnormal activation of immune cells and persistent inflammatory responses. As an emerging immune mechanism, neutrophil extracellular traps (NETs) play a significant role in the pathogenesis and progression of RA.</p> Recent Findings <p>In recent years, studies have revealed that various drugs and natural products can significantly influence the inflammatory microenvironment and tissue damage in RA by regulating the formation and release of NETs. This article systematically reviews currently marketed and investigational agents, including conventional antirheumatic drugs, biological agents, small-molecule inhibitors, Chinese herbal medicines, and nanoformulations, with a focus on evaluating their regulatory effects on NETs in RA and associated therapeutic outcomes. Through a comprehensive analysis of drug mechanisms, clinical efficacy, and safety profiles, this review explores the balance point of NETs-modulating therapeutic strategies, providing a theoretical basis and future research directions for precision medicine in RA.</p>