This previous studies documented a variable severity and prevalence of autonomic neuropathy (ANP ) in systemic lupus erythematosus (SLE) ranging from 0:90%. The aim of this study is to assess the prevalence and severity of autonomic dysfunction ( AD ) in SLE using noninvasive cardiovascular reflex tests. Six noninvasive cardiovascular reflex tests was performed to 30 SLE patients, all fulfilling the revised criteria for classification of SLE (Tan et al., 1982) and 15 healthy controls. Disease activity was assessed using systemic lupus erythematosus disease activity index (SLEDAI) score. The results of the cardiovascular reflex tests were as the following : nine patients (30% ) showed abnormal heart rate response to Valsalva maneuver. One patient (3.3%) showed abnormal heart rate response to deep breathing. Twenty eight patients (93.3%) showed abnormal blood pressure response to sustained handgrip. Eleven patients (36.7%) showed abnormal blood pressure response to standing up. No patient showed abnormal heart rate response to standing up nor to sustained handgrip. All the controls showed normal response to all of the above cardiovascular tests. According to Ewing’s recommendations to categorize AD to 5 groups (Ewing and Clarke, 1986), the results were as the following : twelve patients (40%) had early involvement of the Autonomic nervous system ( ANS ). Two patients (6.7%) had definitive involvement of the ANS. Nine patients (30%) had severe involvement of the ANS. Seven patients (23.3%) had atypical pattern of involvement of the ANS. There was no correlation of the cardiovascular reflex tests results when compared with age, disease duration or disease activity. Conclusion: AD is not uncommon in SLE. The identification of AD in SLE is important for symptom control and may lead to further understanding of the pathophysiology of SLE.