Outcomes in systemic lupus erythematosus (SLE) can be described in three domains: disease activity, accumulated damage and health-related quality of life (HRQoL). Over the past decade, our understanding and perception of SLE have changed considerably. Gastrointestinal and ophthalmic manifestations have increasingly been recognised, and they are associated with significant morbidity and mortality. Furthermore, it has been realised that there is a deficiency in using generic scales (such as the short form-36 (SF-36)) to assess HRQoL in patients with SLE as they fail to identify issues that are important to patients. As a result, SLE-specific measures of HRQoL have been developed recently. This article looks at the recent updates and changes in the standardised assessment of disease activity and HRQoL in SLE.