To investigate the frequency of angiotensinconverting enzyme (ACE) gene insertion/deletion (I/D) polymorphism genotypes in adults with psoriatic arthritis (PsA), a heterogeneous chronic disease with autoimmune pathology. ACE gene I/D polymorphism inXuences the plasma and tissue levels of ACE and has an involvement in inXammatory mechanism. The frequency of ACE gene I/D polymorphism genotypes was determined in 51 adults with PsA from Kuwait, and compared to that in 100 ethnically matched healthy controls using polymerase chain reaction. The distribution of ACE I/D polymorphism and allele frequencies in PsA patients were not signiWcantly diVerent from controls (P > 0.05). Further analyses of PsA patients showed that ACE I/D gene polymorphism was not associated with family history, clinical manifestations, and disease severity. However, the frequency of II genotype was signiWcantly higher in patients with late disease onset than in those with early onset (25 vs. 3%; P = 0.04). No diVerence was found between the distribution of the ACE genotype in PsA patients and the general population in Kuwait.However, the presence of II genotype may confer susceptibility to the development of late onset PsA.