Rituximab is a CD20 chimeric monoclonal antibody. It was approved by the US Food and Drug Administration for the treatment of relapsed or refractory low-grade or follicular non-Hodgkin lymphoma and for the treatment of moderate to severely active rheumatoid arthritis. It has been used as an off-label treatment in many autoimmune diseases, where B cells play a major role in the pathogenesis. We report a case of successful use of rituximab in the treatment of refractory bullous systemic lupus erythematosus in an African American patient.