The Fifth International Congress on Familial Mediterranean Fever and Systemic Autoinflammatory Diseases (Rome, Italy, 4-8 April, 2008) reviewed developments in the field of innate immunity and discussed their relevance to the pathogenesis of associated diseases. The meeting gathered over 300 participants from 32 countries. New modes of inheritance of autoinflammatory diseases, animal models, novel related genes and the remarkable efficacy of IL-1beta blockage in most of these diseases were emphasized.