Over the past 30 years there has been an increase in the survival rate in systemic lupus erythematosus (SLE). As patients with SLE live longer, clinicians involved in their care are confronted with the longterm morbid complications that result either from previous SLE disease itself or as a complication of therapy. Our paper deals with the changing pattern of morbidity in SLE and specifically highlights 3 aspects: atherosclerosis, avascular necrosis and neuropsychological dysfunction. These must be considered as added features in the disease spectrum of SLE.