BACKGROUND: People with rheumatoid arthritis (RA) frequently use dietary interventions such as Mediterranean diet (MedDiet) and exercises to complement pharmacotherapy. OBJECTIVE: To investigate the effect of adding MedDiet to a designed exercise program on quadriceps and hamstrings muscles performance, pain, C-reactive protein (CRP), handgrip strength, bodyweight, and function in females with RA. METHODS: Sixty females were allocated randomly to the MedDiet plus exercise program ( RESULTS: The MedDiet group showed statistically significant improvements in all the measured outcomes than the control group ( CONCLUSION: Adding MedDiet to aerobic and strengthening exercise program improved quadriceps and hamstrings muscles performance, pain, functional ability, CRP, handgrip strength, and body weight. Consequently, Mediterranean diet should be considered as adjunctive therapy in treating females with RA.