To describe rheumatic syndromes that can be a paraneoplastic manifestation of an underlying malignancy. The pathogenesis of paraneoplastic rheumatologic diseases is complex and not fully understood in the majority of instances. In the absence of a defined pathogenic link between the malignancy and the rheumatic syndrome, the association between these diseases has been based on concurrence and a parallel clinical course.This is an updated review of paraneoplastic presentations of synovitis, bone disease, myositis, and vasculitis.Although paraneoplastic rheumatic syndromes are rare, clinicians should be aware that they can be the first sign of an occult malignancy and that early recognition is vital for early cancer diagnosis and treatment.