OBJECTIVE: This study was designed to identify the risk factors associated with seizure attack in patients with systemic lupus erythematosus (SLE) and to propose the usefulness of them as predictive factors for seizure attack. METHODS: One hundred patients with SLE were included in this study. Twenty-five of these patients had seizure attacks during the course of their disease and age-, sex-matched 75 patients who did not have seizure were control group. We compared clinical manifestations and laboratory findings between the two groups. Seizures not related to SLE were excluded. RESULTS: Risk factors associated with seizure attack in SLE were high damage index at initial presentation and the presence of anticardiolipin antibody IgG regardless of its titer. Underlying illness other than SLE, duration of SLE, presence of previous organic brain abnormality, SLEDAI at initial presentation, clinical manifestations of SLE, laboratory findings (including hematologic, immunologic parameters and known laboratory activity indices) and medications before seizure attack were not significantly associated with seizure attack. Recurred seizure was not associated with any of these factors. CONCLUSION: High damage index at initial presentation and the presence of anticardiolipin antibody IgG were associated with seizure attacks in patients with SLE. These factors may be used as predictive factor for seizure attack in SLE.