Objective: To describe the prevalence of sarcopenia in rheumatoid arthritis (RA) patients aged ≥65 years and identify the risk factors associated with sarcopenia. Methods: This is a multicenter, controlled, cross-sectional study of 76 RA patients and 76 age- and sex-matched healthy controls. Sarcopenia was defined according to the revised criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). Whole-body dual-energy X-ray absorptiometry (DXA) was performed. Binary regression was used to assess the relationship between sarcopenia and sex, age, duration of RA, Mini Nutritional Assessment (MNA) score, and Short Physical Performance Battery (SPPB) score in patients with RA. Results: Nearly 80% of participants were female, and the average age was >70 years. Patients with RA had lower muscle mass and greater adiposity (fat-to-muscle ratio mean [SD] 0.9 [0.2] vs. 0.8 [0.2];p= 0.017) than controls, mainly in the central area (android/gynoid ratio, median [p25–p75]: 1.0 [0.9–1.2] vs. 0.9 [0.8–1.1];p< 0.001). Twelve patients (15.8%) and three controls (3.9%) had confirmed sarcopenia (p= 0.014). Sarcopenic obesity was observed in 8/76 patients with RA (10.5%) and in 1/76 controls (1.3%) (p= 0.016). The factors associated with sarcopenia were male sex (OR [95% CI]: 9.3 [1.1–80.4];p= 0.042), disease duration (OR [95% CI]: 1.1 [1.0–1.2];p= 0.012), and nutritional status according to the MNA (OR [95% CI]: 0.7 [0.5–0.9];p= 0.042). Conclusions: Our results suggest that patients with RA aged ≥65 years may be at increased risk for sarcopenia, adiposity, and malnutrition (especially male patients with long-standing disease) and have poor nutritional status.