Systemic lupus erythematosus is an autoimmune disease of unknown etiology with a highly variable clinical presentation. Pleural and pericardial effusions are common in systemic lupus erythematosus and may occur at any time during the disease. In this paper, we present a 31-year-old woman who has reactivation of the disease that was confirmed by the presence of lupus erythematosus cells in pleural effusion with a review of the literature.