Autoantibodies to ribosome P react with the cytoplasmic ribosomes and are specific for the diagnostic of lupus with neurological involvement. The objective of this study was to assess prevalence of serum autoantibodies to ribosome P as a biomarker for lupus with neurological involvement. We measured serum autoantibodies in 47 lupus patients with neurological involvement (range 31-52 years, mean age 38.6 years) as compared to 31 patients with lupus without neurological involvement (range 28-56 years, mean age 41.2 years) and 56 healthy subjects matching with both groups with regard to sex and age. Serum autoantibodies to ribosome P were measured by means of ELISA test. The results were statistically analyzed using the Student t-test. A value of p < 0.05 was considered significant. Autoantibodies to ribosome P were detected in 43 (91%) oflupus patients with neurological involvement and in 7 (15%) lupus patients without neurological involvement (p < 0.001). The results confirm that these autoantibodies are released into the blood, they can be easily measured, and they correlate with outcome including neurological involvement. This study provides additional information with regard to autoantibodies to ribosome P in Romanian lupus population with neurological involvement. Detection of autoantibodies to ribosome P appears useful for diagnostic purpose. Higher peak of serum autoantibodies to ribosome P levels correlated well with neurological involvement (highly specific).