Adipose-derived stem cells (ADSCs) have anti-inflammatory and regenerative properties. The purpose of this study was to investigate the effect of locally administered ADSCs in a rheumatoid arthritis (RA) mouse model. In an in vivo experiment, single-cell ADScs and three dimensionally-cultured ADSc spheroids were injected intra-articularly into the knees of RA model mice and histologically assessed. Marked improvement of synovial inflammation and articular cartilage regeneration was found in ADSCtreated mice. Proliferation, migration, and apoptosis assays of synovial fibroblasts incubated with single-cell and spheroid ADSCs were performed. The expression levels of total cytokine RNA in ADSC single cells, spheroids, and ADSC-treated inflammatory synovial fibroblasts were also evaluated by quantitative reverse transcription PCR. ADSCs suppressed the proliferation and migration of activated inflammatory cells and downregulated inflammatory cytokines. TSG-6 and TGFβ1 were significantly upregulated in ADScs compared to controls and TGFβ1 was significantly upregulated in ADSC spheroids compared to single cells. The apoptosis rate of ADSC spheroids was significantly lower than that of single-cell ADSCs. These results indicated that intra-articular administration of ADSC single cells and spheroids was effective in an RA mouse model, offering a novel approach for the development of effective localized treatments for patients with RA. Rheumatoid arthritis (RA) is an autoimmune disease characterized by synovial inflammation and degeneration of articular cartilage and bone. In previous decades, systemic therapies, including methotrexate and biological disease-modifying antirheumatic drugs, significantly improved the treatment of synovial inflammation 1. Given that RA is a systemic disease, the focus has been to develop systemic treatments for it 2 ; however, swelling persists in some joints with such treatments and the application of systemic treatment is limited due to adverse, off-target effects. Therefore, localized treatment methods are important for treating RA. Corticosteroid injections are the most widely used localized treatment for RA. Although it reduces RA-associated synovitis, repeated intra-articular corticosteroid injections can lead to the degeneration of articular cartilage 3. Other adverse effects of corticosteroids include septic arthritis, local tissue atrophy, tendon rupture, and hyperglycaemia. Consequently, the development of safe, effective, and tissue-regenerating localized therapies must be explored. Recent studies in regenerative medicine have used mesenchymal stem cells (MSCs) derived from somatic tissues such as bone marrow, muscle, blood, and adipose tissue 4,5. MSCs exert anti-inflammatory effects, modulate the immune response, and modify the local microenvironment; furthermore, studies have reported their therapeutic effects for the treatment of inflammatory and autoimmune diseases 6,7. Considering the accessibility and ethical issues associated with the use of MSCs, adipose-derived stem cells (...