Osteoarthritis (OA) is a chronic condition involving degeneration of cartilage within the joints. It is the most common form of arthritis and is associated with pain, substantial disability and poor quality of life.1 Rheumatoid arthritis (RA) is a systemic auto-immune disorder, involving persistent joint inflammation. Non-steroidal anti-inflammatory drugs (NSAIDs) play an important role in controlling the symptoms of arthritis including OA and RA, lower back pain and soft tissue pain, by blocking cyclooxygenase (COX) enzymes. Two COX isoenzymes, COX-1 and COX-2, have important roles in the effects of NSAIDs. COX-1 mediates the mucosal protection of the gastrointestinal (GI) mucosa, while COX-2 is found throughout the body, including joint and muscle and mediates effects on pain and inflammation. By blocking COX-2, NSAIDs reduce pain from different etiologies, such as arthritis, lower back pain, minor injuries and soft-tissue rheumatism.1 NSAIDs that block both COX-1 and COX-2 enzymes are called non-COX-2 selective NSAIDs (nsNSAIDs) and can cause GI bleeding. NSAIDs that target only the COX-2 enzyme, such as celecoxib, are called COX-2 selective NSAIDs and are deemed safer with regards to GI bleeding than nsNSAIDs. Studies found, however, that they may increase the risk of cardiovascular (CV) adverse events. Celecoxib is a commonly used COX-2 selective inhibitor and is indicated for the relief of symptoms associated with OA, RA and ankylosing spondylitis (AS). The purpose of this report is to review the evidence regarding the use of celecoxib in adult patients with OA, RA or other diseases that require pain management. Its clinical effectiveness, safety, and cost-effectiveness are compared with those of nsNSAIDs.