The article reviews the types of pulmonary involvement in patients with rheumatoid arthritis. The most significant lung involvement in patients with rheumatoid arthritis are described, data on its detection frequency, clinical manifestations, diagnostic peculiarities is presented. Information on frequent lung manifestations preceding the rheumatoid arthritis development is presented. The article highlights the latest studies relating to detection of the early immunological markers of rheumatoid arthritis, namely: anti-citrullinated protein antibodies when lung injury is present and no autoimmune disease has been found. The potential role of chronic respiratory infection in triggering the protein citrullination is discussed. The initial changes in the lungs prior to the rheumatoid arthritis development combined with the highly specific rheumatoid arthritis immunological markers make the lungs the potential initial site of the immune disorders associated with rheumatoid arthritis or of rheumatoid arthritis development.