Objective:To evaluate the safety and efficacy of belimumab(BLM) in patients with SLE.Methods:Clinical data were collected for SLE patients who were diagnosed and treated with BLM in the Department of Rheumatology and Immunology (inpatient and outpatient department) of Guilin Medical College Affiliated Hospital from 1 December, 2019 to 12 May, 2023. BLM + standard of care (SOC) for the BLM group and SOC only for the SOC group. The primary clinical endpoint was adverse events (AE) occurring in groups, and the secondary clinical endpoint was disease activity index including SLEDAI-2000, clinical indicators, glucocortoid dosage reduction, and disease flare in the two groups. Propensity score matching method, independent sample t-test, non-parametric rank-sum test, variance analysis were used for statistical analysis. Results:Among the 79 BLM patients included, 48 had hematological impairment (61%), 53 had renal impairment (67%), 11 had skin and mucosal impairment (14%), 20 had joint impairment (25%), and 2 had neurological impairment(3%). There were no serious adverse events during the treatment in both groups. In the BLM group, with 14 cases experienced respiratory system infection, 1 with urinary system infection, 3 with skin infection, 4 with herpes virus infection, and 16 with liver function impairment. In the SOC group, there were 26 cases experienced respiratory system infection, 1 with urinary system infection, 6 with digestive system symptoms, 6 with skin infection, 4 with herpes virus infection, 10 with liver function impairment, 2 with thrombosis, and 1 with sepsis. Patients tolerated BLM generally well, with fewer adverse events occurring [in patients with the long course treatment, the number of AE cases in the BLM group vs SOC group 11 [(33%) vs 22 (68%), ( χ2=3.74, P=0.053)]. From all study groups and high-dose glucocorticoid (≥20 mg) groups, it was observed that the BLM group had a more significant reduction in glucocortoid dose [baseline glocucorticoid reduction in the BLM group decreased from 20 (12, 40)mg/d to 6 (4, 10)mg/d ( Z=0.12, P=0.01). In the renal injury group, after treatment, serum creatinine level decreased in the BLM group glomerular filtration rate increased from 72.37 (41.97, 95.74) to 97.03 (71.18, 114.34) ( Z=-4.62, P<0.001). There was less flares in the BLM group [7 cases (28%) vs 18 cases (72%), χ2=5.58, P=0.018] when compared with the soc group. Conclusion:BLM is safe and effective for the treatment of SLE, which can reduce disease activity, improve clinical parameters, reduce glocucorticoid dosage, and have a low flare rate.