A brief review of the literature devoted to the defeat of the respiratory system in systemic lupus erythematosus (SLE) is presented. The characteristics of the most common diseases, i.e. pleurisy, the defeat of the diaphragm, upper respiratory tract and pulmonary vessels is given. Particular attention is paid to lupus pneumonitis and pulmonary (alveolar) hemorrhage. As an example, here is the case from the authors’ personal therapeutic practice. In the young patient at the acute stage of SLE the leading clinical manifestation was a lung disease manifested by acute respiratory failure, hemoptysis, anemia, and the X-ray picture of bilateral interstitial and alveolar lesions of the lung tissue. Based on the identification of the laboratory picture of active SLE, lupus lung damage of hemorrhagic alveolitis type was diagnosed. After treatment with glucocorticoids (pulse therapy and long-term use of high doses per os ), pulse therapy with cyclophosphamide and cascade plasma filtration the regression of pulmonary manifestations of SLE was achieved.