Systemic lupus erythematosus (SLE) is an autoimmune connective disease, where vascular lesions are one of the typical symptoms. The differentiation of the type of vascular complications in SLE is very difficult, sometimes impossible, and requires an in-depth immune and histopathological approach, and extensive clinical experience. It may play a key role in the choice of treatment strategy and prediction of patient prognosis. SLE is a prototype of a multisystem autoimmune connective tissue disease, marked by immune complex-mediated lesions of blood vessels in diverse organs. Therefore, awareness of the aetiology, pathophysiology, the clinical and histopathogical setting, and SLE-associated vascular complications is of great clinical significance. In this review, the spectrum of vascular abnormalities and the options currently available to treat the vascular manifestations of SLE are discussed.