Psoriatic arthritis is a chronic, disabling disease. Therapies for psoriatic arthritis have been borrowed from rheumatoid arthritis and spondyloarthritis. Traditional DMARDs have shown little effect and there is no evidence that any of these drugs prevented disease progression. Although anti-TNF agents have shown efficacy on symptoms and radiographic progression, these new agents are expensive and not available to all patients. In an attempt to standardize and rationalize their use many national rheumatology associations have set guidelines for the use of these therapies. Recently, the Group of Research and Assessment of Psoriasis and Psoriatic Arthritis, an international group of rheumatologists, dermatologists, and methodologists developed a new set of guidelines. The main advantage of this guideline is that it takes into account all aspects of psoriatic disease, including skin, nail and axial involvement, enthesis and dactylitis. Here we analyze these different guidelines and highlight their strengths and limitations.