Methotrexate typically starts to show improvement in conditions like rheumatoid arthritis within 3 to 6 weeks, but it can take up to around 12 weeks (3 months) or even longer to see the full benefits. Patients often notice symptom relief such as reduced pain and swelling during this period, but it is important to continue the medication as prescribed because the effects accumulate gradually over time. Long-term use may be required for sustained benefits and to slow disease progression.