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Objectives Autoimmune Haemolytic Anaemia (AIHA) represents a serious haematological manifestation of Systemic Lupus Erythematosus (SLE). Reported prevalence estimates vary widely across studies, and evidence guiding optimal management remains limited. This systematic review aimed to determine the prevalence of AIHA in SLE and to summarize treatment outcomes reported in the literature.Methods This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements. PubMed was searched in March 2025 using Medical Subject Headings (MeSH) to identify studies reporting (1) the prevalence of AIHA in SLE (from 2004 onward) and (2) treatment options and outcomes in affected patients (from 1997 onward). Records were selected and assessed according to predefined inclusion and exclusion criteria using Covidence.org. One reviewer conducted the screening, and a second reviewer verified all selection. A weighted mean prevalence was calculated across the included studies and risk of bias was assessed using validated tools.Results Twelve studies were included in the prevalence analysis. These studies reported prevalence rates ranging from 2.7 to 47.5% (weighted mean: 10.7 ±12.4%). A geographic diversity was evident among the studies, and different SLE classification criteria were used. Definitions of AIHA were inconsistent across the included studies. Fifty studies were included in the treatment outcome analysis. Prednisolone was the most frequently reported therapy (35% of included patients). Rituximab showed the highest response rate (86%), followed by mycophenolate mofetil (76.9%) and hydroxychloroquine (75%) ( table 1).Abstract PO:10:262 Table 1Summary of treatment outcomes and efficacy of the drugs reported in the literatureConclusions This systematic review identifies AIHA as a significant, yet inconsistently reported complication of SLE, with prevalence estimates influenced by geographic region, classification criteria and AIHA definitions. Corticosteroids remain the first-line treatment; however, rituximab demonstrates the highest reported efficacy. These findings highlight the need for standardized diagnostic definitions and prospective comparative studies to optimize management strategies, potentially allowing for reduced corticosteroid exposure and improved patient outcomes.