Arthritic psoriasis is a type of psoriasis with chronic progressive involvement of the joints. Most patients with arthritic psoriasis have involvement of the distal joints of the extremities, and some patients may have sacroiliac arthritis, crepitus, sternoclavicular arthritis, temporomandibular arthritis and so on. The clinical manifestations are pain, swelling, stiffness, pressure pain and movement disorders in the joints and surrounding soft tissues, and in the advanced stage, the involved joints may be ankylosed and deformed, causing great harm to patients physically and mentally. The goals of treatment for arthritic psoriasis are to relieve symptoms, prevent or delay structural damage, protect the patient’s life functions and social participation, and improve the patient’s quality of life to the greatest extent possible. The treatment of arthritic psoriasis includes general therapy, medication, rehabilitation, and surgical treatment of deformed joints. Traditional arthritic psoriasis treatment drugs include non-steroidal anti-inflammatory drugs, anti-rheumatic drugs to improve the condition, glucocorticoid steroids, etc. In recent years, biological agents have been more widely used in the treatment of arthritic psoriasis. In this article, we mainly talk about the graded treatment of drugs (I-IV treatment). Grade I treatment refers to oral NSAID treatment. When clinically diagnosed as active arthritic psoriasis, it enters the primary treatment, and after 3-6 months, if it is effective, continue the treatment; if it is ineffective, transfer to the secondary treatment. When there are 5 or more active joints; or with severe functional impairment or structural damage; or with a history of glucocorticoid treatment; or with extensive skin involvement, the patient enters directly into level II-IV treatment according to the situation. Level II treatment refers to anti-rheumatic drug therapy, such as MTX, salazosulfapyridine, and leflunomide. Such drugs may slow or stop the immune system’s attack on the joint, thereby relieving pain and swelling and possibly delaying or stopping the progression of joint damage, but are ineffective for joint damage that has already occurred. When Level I therapy is not effective or when drug toxicity is not tolerated or is associated with poor prognosis, proceed to Level II therapy (MTX); if MTX is contraindicated, treat with leflunomide or salazosulfapyridine (or cyclosporine A); after 3-6 months, continue treatment if effective; if not, proceed to Level III therapy. In cases of predominant mid-axis arthropathy or severe enthesitis, go directly to level III. Screening blood tests are required before treatment with anti-rheumatic drugs, and blood tests, liver function and serum creatinine should be repeated at least once every three months during treatment. Level III treatment is biological agent therapy. Since 2000, TNF-α inhibitors have played a major role in the treatment of psoriasis and psoriatic arthritis and have been effective in the improvement of most clinical symptoms, including skin, nails, mid-axis or peripheral joints, tendonitis, and phalangitis. Commonly used TNF-α inhibitors include etanercept, infliximab, etc. A second anti-rheumatic drug therapy or combination therapy is started when grade II therapy is not effective or grade II drugs are toxic, but there are no poor prognostic factors. When grade II therapy is ineffective or grade II drugs are toxic, but with poor prognostic factors or predominantly mid-axis arthropathy, or with severe attachment site inflammation, start TNF-antagonist therapy (± antirheumatic drugs). 3-6 months later, if effective, continue therapy; if ineffective, switch to grade IV therapy. Level IV treatment refers to rotational treatment. When level III treatment is not effective or level III drugs are toxic, the TNF-antagonist treatment strategy needs to be changed to a second TNF-antagonist treatment (± antirheumatic drugs). 3-6 months later, if effective, continue treatment; if ineffective switch to a combination drug strategy.