In contrast to many other medications, chloroquine and hydroxychloroquine are approved treatment options for systemic lupus erythematosus (SLE). Antimalarials reduce the frequency of disease flares and contribute to the maintenance of remission. Apart from its direct effects on SLE activity, antimalarials seem to protect against thrombotic events and have a beneficial effect on glucose and lipid profiles, which might help reduce the high cardiovascular risk of SLE. Hydroxychloroquine is the only treatment shown to be effective in reducing the risk of damage accrual in SLE patients. Finally, antimalarials are inexpensive, especially compared with more recent treatments, and are well tolerated in SLE. Despite all these benefits, still only about 40%-50% of SLE patients are treated with (hydroxy)chloroquine. Particularly in early disease phases, antimalarials should be considered for every lupus patient, assuming there are no contraindications.