One hundred and fifty six Chinese patients with Systemic Lupus Erythematosus (SLE) were studied prospectively over 50 months. The patients in the retrospective group (Group I) were diagnosed before and in the prospective group (Group II), at the time of entry into the study. The overall female to male ratio was 25:1 with mean age at onset (+/- SD) of 26 +/- 9.9 years. Neurological manifestation as the presenting feature was rare (3%), and none of the untreated patients presented with infection. Anti-nuclear antibody (ANA) was positive in 94% and anti double stranded-DNA antibody (anti DNA) 65%. New manifestations developed in 34 patients (26%) and 218 episodes of relapses occurred in 100 patients with a rate of 0.042 relapse per patient month. Five patients died during the study period with a 5 year survival of 97% and 10 year survival of 94% in the cohort. There was no significant difference in survival between Group I and Group II patients at 50 months (p = 0.72).