Evidences indicate that angiogenesis is an important process in the development of destructive synovial tissue in rheumatoid arthritis (RA). Recently, it has been shown that the polymorphism of the integrin-αv subunit encoded by the ITGAV gene plays a role in angiogenesis and is considered as RA susceptibility loci. This study investigated association of four single nucleotide polymorphisms (SNPs) in ITGAV with disease activity score (DAS28), serum levels of C-reactive protein (CRP), and anti-cyclic citrullinated peptide(anti-CCP) antibody in 419 RA patients and 398 healthy individuals. Four SNPs in ITGAV gene (rs3911238, rs3738919, rs10174098 and rs3768777) were analyzed. Serum concentrations of anti-CCP antibody and CRP were measured by ELISA. We used the EULAR activity criteria to calculate DAS28-CRP. Among these SNPs, the ITGAV-rs3911238-G/C polymorphism was associated with RA disease activity [remission-to-low and moderate-to-high in codominant model (CC vs.GG: OR=1.53, p=0.041 and allele (C vs. G: OR=1.18, p=0.042)] and presence of anti-CCP (codominant CC vs.GG: OR=2.77, p=0.001, allele C vs. G: OR=1.19,p=0.033). The carriers of CC genotype ITGAV-rs3911238 had higher serum levels of CRP and anti-CCP antibody titer and higher ESR and disease activity score than carriers of GG and CG genotypes. Furthermore, haplotypes analysis showed that ITGAV rs3733891C/rs3768777T/rs3911238C/rs10174098A and ITGAV rs3733891A/rs3768777T/rs3911238G/rs10174098A haplotypes increased severity and anti-CCP antibody in RA patients (OR=5.54, p=0.049 and OR=2.89; p=0.024, respectively) in comparison with ITGAV rs3733891C/rs3768777T/rs3911238G/rs10174098A haplotypes. Thus, the present study demonstrated that the link between systemic inflammatory markers and the ITGAV-rs3911238 polymorphism allele in Iranian RA patients.