Tocilizumab, a humanized monoclonal antibody targeting the interleukin-6 receptor, has demonstrated significant efficacy and tolerability in patients with rheumatoid arthritis (RA) who have had an inadequate response to conventional synthetic disease-modifying antirheumatic drugs or tumor necrosis factor inhibitors. Despite its effectiveness in controlling inflammation, tocilizumab is associated with serious adverse events, including gastrointestinal perforation, a rare but potentially life-threatening complication. This report presents a case of colon perforation in a patient with RA receiving tocilizumab therapy.