Early diagnosis of subclinical atherosclerosis can be established using noninvasive imaging techniques, which enable to assess atherosclerotic lesions at different stages of their development, from endothelial dysfunction, through morphological lesions in the arteries, to advanced atherosclerotic plaques. Given high risk of accelerated development of atherosclerotic lesions in patients with systemic lupus erythematosus (SLE), these techniques should be incorporated in routine diagnostic evaluation in this population. Cardiovascular risk factors in patients with SLE differ significantly from those observed in the general population. Chronic inflammation and the presence of autoantibodies play the key role, while classic risk factors are less important. Subclinical atherosclerotic lesions can be detected in 30% to 40% of the SLE patients. The occurrence of severe symptoms in the cardiovascular and central nervous systems can be caused by such lesions. Recent data indicate that the main causes of death in this patient group represent cardiovascular complications. Early identification of patients in the risk group allows to implement appropriate prophylactic and therapeutic procedures.