Objective: The present study has been under taken in order to determine whether anti-cyclic citrullinated peptides antibodies (anti-CCP) auto-antibody, could define a subset of patients with lupus with erosive disease. If possible, their levels will be measured in the sera of patients and correlated with clinical activity, laboratory manifestations and radiological findings of the disease.Methods: Fifty-five female SLE patients and a control group of 20 healthy subjects with matching age and sex were included in our study. Anti-CCP antibodies levels were measured in human serum using the ELISA technique. Rheumatoid factor (RF) was measured using latex fixation test. Routine plain X-rays were done to both hands joints & were assessed using Sharp/ Van der Heijde method. Disease activity was assessed using the SLE Disease Activity Index (SLEDAI). The disability and discomfort in our patients was assessed using Short or (2 page) Standford Health Assessment Questionnaire (HAQ). The disease activity as regard arthritis in our patients was assessed using modified disease activity scores that include 28 joint counts (DAS 28).Results: The mean levels of anti-CCP antibodies were significantly higher in the whole SLE patients group (21.84 ± 16.46) than in the healthy controls group (14.95 ± 6.4), with (P < 0.01). 7 SLE patients (12.7%) had elevated serum anti-CCP levels above 36 units. All of our seven patients with elevated anti-CCP of (12.7%) had persistent arthritis, only 5 patients (71.1%) of them had erosions. Positive significant correlations were found between number of swollen joints (P= 0.02), number of tender joints (P= 0.00), patient’s global assessment (P= 0.002) and score of DAS28 (P= 0.002) with anti-CCP levels. Moreover, Positive significant correlations were found between radiological parameters (i.e. score of narrow joints, score of erosions and maximum damage score) and anti-CCP levels with (P< 0.01). RF was found in 15 SLE patients (27.2%), and it was significantly more prevalent in patients with elevated anti-CCP levels (71.4%) than those with normal level (20.8%) with (P= 0.005). Also we found that age and disease duration of SLE patients were significantly correlated with the levels of anti-CCP with (P= .001 & 0.009, respectively). Functional disability assessed using HAQ was significantly positively correlated with anti-CCP levels with (P= 0.009). Also there was significant positive correlations between pain assessed with (VAS) with (P= 0.002) and anti-CCP levels. Interestingly, we found that the prevalence of Sicca syndrome was significantly higher in SLE patients with elevated anti-CCP levels with (P=0.01). However, there was no correlation between the score of disease activity (SLEDAI) and anti-CCP levels.•Conclusion: We can conclude that anti-CCP auto-antibodies, first identified in patients with RA, can define a subset of patients with lupus present with arthritis particularly those with old age, long disease duration, and who have radiological changes in the form of erosions and joint narrowing. Also, elevated anti-CCP antibodies levels are correlated to functional impairment in our patients, while they are not correlated to the score of disease activity (SLEDAI). Moreover, we conclude that in SLE patients with arthritis, a combination of anti-CCP antibodies and RF have a high predictive value to identify patients with disease destined to develop SLE with erosive arthritis (Overlap syndrome or Rhupus) who may be appropriate for very early intervention