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This study examined the relationship between ways of coping and psychosocial adjustment to illness in cardiac transplant recipients and patients with chronic rheumatoid arthritis. The research questions were: (1) What coping patterns and levels of adjustment to illness are identified by heart transplant patients and rheumatoid arthritis patients? (2) What are the relationships between ways of coping and psychosocial adjustment to illness within these two populations independently and as a total chronic illness group? (3) How are cardiac transplant recipients similar to and different from patients with chronic rheumatoid arthritis regarding coping behavior and adjustment to illness? (4) Do specific coping styles seem to be linked to adjustment in certain life domains? Participants included 64 adults with rheumatoid arthritis and 66 adults who were cardiac transplant recipients. The subjects each completed two questionnaires, the Psychosocial Adjustment to Illness Scale and the Ways of Coping scale. They also answered four questions generated by the researcher which attempted to quantify frequency of symptoms and related degree of stress and perceived control over daily symptoms and long-term course of illness. This study provided some evidence that people use the same coping strategies regardless of medical diagnosis. The data also suggested that coping through distancing and escape-avoidance may result in relationship problems and possibly increased psychological and work-related problems. Further research should be conducted to examine how coping mechanisms are learned and how one's coping repertoire can be expanded to include more useful strategies.