Tehran University of Medical Sciences Immunology and Genetics Journal 2645-4831 8 2 2025 03 04 203 212 Shakiba Yousefi Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran Vahid Mansouri Gene Therapy Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 2025 02 25 2025 03 04 Fibromyalgia (FM) is a complex and debilitating rheumatologic syndrome characterized by chronic widespread pain, fatigue, and cognitive disturbances. Despite extensive research, its pathogenesis remains poorly understood, and reliable biomarkers for diagnosis are lacking. Emerging evidence suggests a critical role of immune dysregulation in FM, highlighting its potential classification as an autoimmune-related disorder. This review explores the immunological aspects of FM pathogenesis, including its association with autoimmune comorbidities, the presence of autoantibodies, and the involvement of inflammatory cytokines. Additionally, we discuss recent findings that support an autoimmune basis for FM, such as the transfer of FM symptoms through patient-derived IgG in animal models. Recognizing these immunological connections may pave the way for improved diagnostic approaches and targeted therapeutic strategies for FM.   https://igj.tums.ac.ir/index.php/igj/article/view/199 https://igj.tums.ac.ir/index.php/igj/article/download/199/177