ABSTRACT Context: Stretching and strengthening for rheumatoid arthritis of the hand (SARAH) is a progressive and individually designed recommended treatment exercise program. Aims: The aim was to translate the SARAH hand exercise program into Gujarati and assess the adherence rate, usefulness, and understanding of the Gujarati SARAH exercise program. Methods and Materials: Mixed-method qualitative study was conducted among 25 participants at the outpatient departments of Institute Nadiad and Niruj Rheumatology Clinic, Gujarat, and via professional contact, a telephonic semi-structured interview was conducted among 13 participants using an interview guide, and interviews were audio-recorded following transcription verbatim. Overall adherence rates of 25 participants to a 12-week exercise program were determined using the cross-sectional method. Statistical Analysis Used: IBM SPSS software version 23.0 was used for analyzing quantitative data, and NVivo Plus version 11 was used for qualitative data. Results: The adherence rate was 97.22%. Participants completed all 72 sessions (n = 7) with an adherence rate of 100%. The least number of sessions completed was 25 (n = 2), with an adherence rate of 34% due to a lack of interest in exercising on a daily basis. Qualitative findings showed that the booklet is understandable, useful, and beneficial in terms of reducing symptoms and improving activities of daily life as well as occupational work. Conclusion: The translated strengthening and stretching for rheumatoid arthritis in the hand exercise booklet is effective and beneficial to patients who exercise at home. Participants can self-track their exercise by using dairy, which eliminates travel costs and attendance at clinic sessions.