The objective of the present study was to elucidate the mode of rheumatoid arthritis shoulder destruction. The study included 402 shoulders from 201 patients with rheumatoid arthritis. Plain radiographic findings were used to assess and statistically analyze the severity of the glenohumeral joint destruction (GHD) and greater tuberosity destruction (GTD). For both GHD and GTD scores, a statistically significant correlation was found between the left and right sides and also between the GHD and GTD scores within the same shoulder. However, 97 shoulders of 67 patients showed a heterogeneous pattern. An interesting finding was that no patients showed a combination of the GHD type plus the GTD type. Shoulders with rheumatoid arthritis showed statistically significant symmetry and uniform destruction. Even if they showed heterogeneous destruction, there were no cases of a different pattern of heterogeneity on the opposite side. The mode of destruction was not always definite, however.