In 2020, clinical studies have opened the way for several new treatment options in rheumatoid arthritis, psoriasis arthritis, spondylarthritis and lupus. However, this year was mainly characterized by the Covid-19 pandemic which had a substantial impact on rheumatology. The initial fear for immune-compromised patients undergoing more severe Covid-19 courses remained without evidence. The same was true for the hype of several rheumatic treatments such as Plaquenil or anti-IL-6 blockade which finally did not show efficacy in prospective trials for Covid-19 pneumonia. On the other side, notably the first confinement had a substantial negative impact on rheumatic patients. Our patients are still struggling with the consequences of prolonged immobilization, lack of physiotherapy, missing consultations and treatment adaption as well as social isolation and depression. Telemedicine and upcoming digital solutions compensated this gap at least partially. The post-Covid syndrome with persisting fibromyalgia-like symptoms potentially will join the spectrum of rheumatic disorders.