Abstract The last 2 years have marked the beginning of a golden age for natural language processing in medicine. The arrival of large language models (LLMs) and multimodal models have raised new opportunities and challenges for research and clinical practice. In rheumatology, a specialty rich in data and requiring complex decision-making, the use of these tools may transform diagnostic procedures, improve patient interaction and simplify data management, leading to more personalized and efficient healthcare outcomes. The objective of this article is to present an overview of the status of LLMs in the field of rheumatology while discussing some of the challenges ahead in this area of great potential.