Key Points • For a 1-year increase in total duration of prednisone use in RA patients, the adjusted OR for RA-associated cervical spine deformity was 1.17 (95% CI, 1.01–1.36; p = 0.04). • For an increase in total cumulative dose of 1 g of prednisone in RA patients, the adjusted OR for RA-associated cervical spine deformity was 1.06 (95% CI, 1.00–1.11; p = 0.04). • The use of glucocorticoids in RA patients was associated with an increased odds of RA-associated cervical spine deformity after 10 years, which may suggest that other effective therapies to suppress disease activity should be preferred over glucocorticoids.