Nocardiosis is an uncommon complication in children with systemic lupus erythematosus (SLE). This is a case report of pulmonary nocardiosis in a 13 year-old girl with SLE, who presented with fever, chest pain and tachypnea. She had been treated with steroids and cytotoxic agents for five months. Nocardia asteroides was isolated from a surgical specimen culture. The pulmonary nocardiosis was treated by surgical excision in combination with trimethoprim-sulfamethoxazole. Nocardia sp should be considered as a possible agent of infection in immunocompromised patients, especially those treated with corticosteroids at the time of infection.