The study assessed the knowledge, perceptions and clinical practices of rheumatologists in Arab League Associations for Rheumatology (ArLAR) countries regarding biosimilars through a 19-question web-based survey. It was attended by 105 rheumatologists with an average age of 43.6 ± 11.7 years, of which 61.9% were women, mostly adult specialists from Iraq (37.1%), Morocco (19%) and Algeria (16.2%). As many as 85.7% reported the use of biosimilar medicines in practice, but only 50.5% correctly identified their formal definition. Comfort with EMA/FDA approved drugs was high (mean score 4.22/5), but concerns about switching in stable patients and between multiple biosimilars remained. The majority (80%) wanted further education, particularly on validation, extrapolation and security. Rheumatologists show high uptake of biosimilars but average understanding of regulatory and clinical concepts, so regional education programs are needed.