The role of systemic lupus erythematosus (SLE) in the development of acute pancreatitis is a matter of controversy since, in many cases, this complication has been attributed to the drugs administered. In this study, we present a patient diagnosed as having SLE who developed acute pancreatitis with no apparent cause aside from her basic disease, and in whose necropsy was observed vascular damage consisting of severe intimal proliferation. Pancreatic vascular lesions in previously reported patients with lupus are reviewed.