To report the cumulative articular and extra‐articular damage in Arab children with JIA and identify variables that correlate with disease damage. We conducted a multicenter, cross‐sectional study among 14 pediatric rheumatology centers from seven Arab countries. JIA patients who met the ILAR classification criteria and had a disease duration greater than one year were enrolled. Disease activity status was assessed using the Juvenile Arthritis Multidimensional Assessment Report (JAMAR). Disease damage was assessed by articular and extra‐articular juvenile arthritis damage index (JADI‐A and JADI‐E).

A total of 702 (471 female) JIA patients with a median age of 11.3 (IQR 8.0‐ 14.0) years were studied. The median age at disease onset was five (IQR 2.0‐ 9.0) years, and the median disease duration was four (IQR 2.0‐ 7.0) years. The most frequent JIA categories were oligoarticular JIA (34.9%), polyarticular JIA (29.5%), and systemic JIA (24.5%). Clinical remission was achieved in 73.9% of patients. At the last clinic visit, 193 patients suffered from joint damage with a mean JADI‐A score of 1.7 (SD ±4.5), while 156 patients had extra‐articular damage with a mean JADI‐E score of 0.5 (SD ±1.1). Patients with enthesitis-related arthritis (ERA) had the highest JADI‐A score. JADI‐A correlated significantly with the presence of a family history of JIA. JADI‐A and JADI‐E had a significant correlation with long disease duration.

Cumulative damage was common in this Arab JIA cohort, and consanguinity and JIA in a sibling were frequent findings and were associated with more significant cumulative damage.