A 33-year-old female was admitted to the intensive care unit (ICU) due to respiratory failure. During her ICU stay, she developed multiple organ failure and neuropsychiatric symptoms, and was diagnosed with neuropsychiatric systemic lupus erythematosus (NPSLE). The patient faced difficulties in activities of daily living (ADL) recovery due to severe psychiatric symptoms and generalized muscle weakness; however, after one year of rehabilitation intervention, she achieved independence in ADL. NPSLE may occur more common in cases with high disease activity. Therefore, it is essential to consider the neuropsychiatric symptoms and implement rehabilitation interventions accordingly among critically ill patients with SLE. Additionally, as physical function improves following psychiatric symptom improved, rehabilitation intervention should aim for ADL recovery with disease activity and neuropsychiatric symptoms as indicators.