Twenty systemic lupus erythematosus patients under the age of 16 who had attended the Pediatric Department of Songklanagarind Hospital in the period 1985-1991 were reviewed retrospectively. The most common complaints were fever, alopecia, malar rash and oedema. The girl/boy ratio was 2.3/1. There were many unusual presentations such as Stevens-Johnson syndrome, psoriasis, rheumatoid nodules, papillitis and pseudotumor cerebri. Nephritis, haematological disorder and CNS involvement were found in 80, 50 and 35% respectively. All cases were positive for ANA. Sixty-five percent of cases had complications and mostly more than one. Common complications were infection, renal complication and side effects of chemotherapy. Five patients died because of renal failure, severe infections, cerebral infarction or GI bleeding.