We describe the clinical and roentgenographic findings in the hands of 13 patients with primary biliary cirrhosis. A nondeforming, generally asymptomatic erosive arthritis was present in 12 of 13 patients. The erosions were asymmetrically distributed and mainly involved the distal small joints of the hands. Seven patients had osteopenia due to hepatic osteodystrophy. Intraosseous lytic defects were present in three patients, chondrocalcinosis in two patients, and hypertrophic osteoarthropathy in one patient. We discuss the importance of the clinical and roentgenographic features of the arthritis of primary biliary cirrhosis.