Purpose of the Review We will address current treatment and unmet needs in psoriatic arthritis (PsA), examine existing randomized controlled trials (RCTs), and consider options for new trial designs and challenges in their implementation. Recent Findings While therapeutic options for PsA have rapidly increased, there continues to be a need for clinical trials to test new therapies and establish optimal treatment strategies in order to improve the care for patients with PsA. In addition, more data is needed on how to select the best therapy for a given patient in clinical practice. Consideration of alternative outcome measures is also needed. Summary Despite the rapid expansion in the number of therapy options available, there is still much to be learned about how to treat the individual patient with PsA.