Spondyloartrhitis (SpA) are a group of diseases characterized by inflammation at articular and entheseal sites. Moreover, patients with SpA suffer from impaired articular function and reduced quality of life. Beyond the articular involvement, SpA and in particular psoriatic arthritis (PsA) are associated with extra-articular manifestations and comorbidities that might increase the burden of the disease. The aim of this article was to review the available evidences on the presence of comorbidities in SpA, including PsA, focusing the attention on the cardiovascular, metabolic aspects, as well as other comorbidities, and their possible management in an integrated manner. Comorbidities in SpA should be carefully evaluated because of their important impact.