Systemic rheumatoid vasculitis (SRV) is an uncommon but potentially serious complication of RA. The incidence of SRV is unknown. The aim of this study was to estimate the incidence of SRV in the UK. Over a 6-yr period vigorous attempts were made to identify all patients with newly diagnosed SRV living within the Norwich Health Authority (NHA). The overall annual incidence of SRV is 12.5/million (95% CI: 8.5–17.7). The annual incidence rate for men was 15.8/million (95% CI: 9.5–24.7) and 9.4/million (95% CI: 4.8–16.4) for women. The incidence of SRV in this study is higher than previous estimates.