Cardiovascular disease is one of the leading causes of deaths in patients with systemic lupus erythematosus (SLE). It occurs more often and at a younger age than in the general population (Table I). The causes of this phenomena have not yet been explained. Accelerated atherosclerosis is related to elevated total cholesterol, coexisting autoimmunization and chronic glucocorticoids treatment. In practice, patients with SLE are treated as a group of high risk of cardiovascular complications. In the paper authors present classic and SLE – specific risk factors leading to atherosclerotic vascular events (Table II). Attention is focused on probable benefits of antimalarial treatment. The significance of additional imagining investigations, including carotid duplex for assessment of intimae media thickness/plaque, in diagnosis of atherosclerosis is reviewed. At the moment no clear recommendations have been defined related to primary and secondary preventive methods for SLE patients. Finally, a strategy of management is proposed (Table III).