Background:Smoking is one of the main environmental risk factors involved in several rheumatic diseases according to ACR 2014, it is included among the risk factors for severe axial spondyloarthritis.Objectives:The objective is to study the association between smoking and the activity of the disease, the functional impact and the severity of the axial spondyloarthritis.Methods:It is a transversal study with a descriptive and analytical aim, during the period between January 2014 and December 2015 conducted in the department of rheumatology at the CHU Hassan II of Fes.The data was recorded and analyzed using SPSS v20 univariate and bivariate analysisA value of p <0.005 has been used to identify factors associated with smoking.Results:The study included 214 patients, 130 men and 84 women. The mean age was 39.77 ± 13.06 (16-68) years with an average disease duration of 7.97 ± 6.4 (2-35) years.The prevalence of smoking in patients with spondyloarthritis was 36%.According to the univariate and bivariate analysis: Smoking was associated with the male sex (p≤0.0001), with a functional impairment BASFI (p = 0.038) and activity BASDAI (p=0.004) and ASDAS CRP, (p=0.036).Multivariate logistic regression analysis suggested that smoking was associated with male sex and the severity of the disease.Conclusion:Our study suggests that there is a significant association between smoking and male sex and the severity of the disease.