Cardiovascular disease is a major cause of death in patients with systemic lupus erythematosus (SLE), especially during the late phase of the disease. Ventricular diastolic dysfunction is considered one of its common findings and may preceed systolic dysfunction with overt morbidity and mortality. There is also some evidence about the association of antiphospholipid (aPL) antibodies with ventricular diastolic dysfunction in children with SLE. This study aimed at evaluating the prevalence of echocardiographically documented diastolic dysfunction in patients with SLE with and without anti-phospholipid antibodies, and to examine whether these antibodies are associated with diastolic dysfunction independently of valvular abnormalities and systolic dysfunction. Methods: Pulsed, continuous, colour Doppler echocardiography was performed on 65 patients with SLE, with simultaneous synchronized ECG monitoring, 3 patients were excluded from the analysis due to systolic dysfunction or severe valvular disease. Results: 30 patients (48.4%) had +ve aPL antibodies, the majority of patients showed diastolic dysfunction especially of the left ventricle: 44 patients (71%) showed increased A velocity. The E/A ratio was inverted in 31 patients (50%), with shortening of the left ventricular deceleration time in 50 patients (80.6%), shortening of LV IVRT in 25 patients (40.3%) and prolongation of LV IVRT in 29 patients (46.8%). The left ventricular Tei index was increased in 26 patients. Regarding the right ventricle, 12.9% of patients showed increased A velocity, the E/A ratio was inverted in 4 patients (6.5%) and was increased in 6 patients showing restrictive pattern of diastolic dysfunction with shortening of RV DT in 42 patients (67.7%) and shortening of RV IVRT in 16/62 patients (25.8%). The right ventricular Tei index was increased in 14 patients (22.6%) denoting global right ventricular dysfunction. The left ventricular diastolic indices (including A wave, E/A ratio, the LV IVRT) and LV Tei index were significantly more affected than the right ventricular diastolic indices with p-value < 0.05. There was strong association between the presence of systemic hypertension and the impairment of the left and right ventricular peak E velocity with P value of 0.02, Odd’s ratio (OR)of 3.7 and P value of 0.03, OR of 4.5 respectively. No significant association was found between aPL and diastolic impairment. Conclusion: Diastolic dysfunction, in particular of the left ventricle that is independent of valvular disease and systolic dysfunction, is a prominent feature of SLE. No association was found between the presence of antiphospholipid (aPL) antibodies and ventricular diastolic dysfunction. Hypertension and the use of high doses of steroids are the major risk factors in the development of diastolic dysfunction. Prompt management of hypertension is mandatory.