Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that can invade any organ or system and has a variety of clinical manifestations, including gastrointestinal symptoms in 30-50% of patients with SLE. Lupus mesenteric vasculitis (LMV) is the most common cause of abdominal pain in patients with SLE. The clinical manifestation of lupus mesenteric vasculitis is mainly abdominal pain, which may be accompanied by diarrhea, abdominal distension, nausea and vomiting, etc. In severe cases, there may be gastrointestinal bleeding or even intestinal obstruction or intestinal perforation. Laboratory tests mainly show positive anti-nuclear antibodies, positive anti-double-stranded DNA antibodies, anti-SSA antibodies and anti-nucleosome antibodies. Routine blood tests may show decreased white blood cells and platelets, and anemia. Urine routine may show proteinuria and stool routine may be positive for occult blood. Blood sedimentation and C-reactive protein are elevated, complement C3 and C4 are decreased, and lipid and immunoglobulin abnormalities may be present. Enhanced CT of the abdomen and intestinal revascularization are important tools for the diagnosis of early LMV. Edema of the intestinal wall is common, and the intestinal wall may show a target-shaped sign. Mesenteric vessels are arranged in a comb-like pattern. The diagnosis of LMV is not standardized and requires a combination of clinical manifestations and laboratory tests and the exclusion of other GI diseases. The treatment of LMV is mainly with glucocorticoids such as prednisone, methylprednisolone and immunosuppressants, fasting, gastrointestinal decompression, antibiotics against infection, anticoagulant rehydration, and correction of water-electrolyte disorders. Patients with lupus who have abdominal pain should think of lupus mesenteric vasculitis. In turn, patients with abdominal pain, especially women, need to notice whether there are other organ involvements such as arthralgia, rash, blood routine changes, proteinuria, complement level, etc. Enhanced CT examination of the abdomen is feasible when available to prevent and treat missed diagnosis and misdiagnosis.