A major current challenge is to identify high-risk patients with rheumatoid arthritis and/or spondyloarthritis in an early stage of disease and to commence treatment without delay. Developments in risk stratification include new classification criteria, identification of clinical risk factors, biomarkers, genetic associations, potential antibody associations and an SpA/RA-specific microbiome signature. Further research needs to focus on the evidence for early intervention and early identification of high-risk individuals. A dedicated early arthritis clinic will improve referral lag time and reduce delay in establishing disease-modifying therapy.  In addition, an early arthritis clinic will not only improve clinical and process outcomes but also achieve significant financial savings for healthcare. The organizational aspect of early arthritis management will possible enhance clinical outcomes but also needs extra manpower for the daily triage of referrals to avoid transit delays.