Rheumatic diseases encompass a wide range of conditions affecting the joints, muscles, and connective tissues. These diseases can lead to chronic pain, inflammation, and varying degrees of disability. African Americans are disproportionately affected by several rheumatic diseases. Studies indicate that African Americans experience higher rates of rheumatic diseases compared with other racial groups. For instance, conditions like rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and osteoarthritis (OA) are more prevalent in this population. Genetic factors play a significant role in the higher prevalence and severity of SLE and RA in African Americans. For SLE, several studies have identified specific genetic loci that contribute to the increased risk and severity in African Americans. Overall, the genetic predisposition in African Americans for these rheumatic diseases involves a complex interplay of ancestry-specific and shared genetic factors, which contribute to the observed disparities in disease prevalence and severity. This chapter includes discussions of specific disorders that disproportionately impact African Americans including systemic lupus erythematosus, scleroderma, gout, and others.