Objectives <p>To assess the prevalence of pleuropulmonary manifestations in a cohort of Jordanian patients with systemic lupus erythematosus and to identify associated factors.</p> Methods <p>This is a retrospective observational study in a tertiary care centre. A comprehensive review of the medical records of SLE patients was performed from 1 January 2000 to 31 December 2023 in order to obtain demographics, clinical data, laboratory, and radiological information.</p> Results <p>A total of 349 patients were included in the analysis. The average age was 43.3 ± 13.6&#xa0;years, and most of this population were female (90.8%). Out of the total patients, 29.5% had at least one pleuropulmonary complication, and pleural effusion was found to be the most frequently reported, followed by pulmonary embolism (7.2%) and pulmonary hypertension (5.4%). Pulmonary function tests were found to have similar obstructive and restrictive patterns in 35.7% of patients. Among HRCT abnormalities, the most common was pleural effusion (33.8%), followed by ground-glass opacity (32.4%) and atelectatic bands (31.7%). Factors associated with the development of pleuropulmonary manifestations were positive lupus anticoagulant, positive anti-ANuA, and positive DCT.</p> Conclusion <p>As many as 29.5% of the patients had pulmonary involvement. Pleural effusion was the most frequent pleuropulmonary manifestation. PFT showed similar percentages of obstructive and restrictive patterns. Factors associated with the development of pleuropulmonary manifestations were positive lupus anticoagulant, positive anti-ANuA, and positive DCT. This study is, to our knowledge, the first long-span Jordanian cohort to characterise pleuropulmonary involvement in SLE while identifying independent immunological predictors (lupus anticoagulant, Anti-ANuA, and DCT) and delineating a distinct distribution of lupus nephritis classes by pulmonary status.</p>