Ethnic differences in systemic lupus erythematosus account for part of the variability in disease susceptibility and expression observed in patients. By studying these racial dissimilarities in a multi-ethnic society, it allows us greater understanding of disease epidemiology, natural history and pathogenesis affected by ethnicity. Disease outcomes and the effects on disability and quality of life have not been well studied in Asian lupus. Ethnic difference in patient perceptions of disease and treatment could also play a large role in adherence and ultimately disease outcome. Future studies that explore these areas may shed insight into better ways either to use existing treatment regimes or to measure efficacy of new therapies in lupus patients. Given the increased susceptibility and more severe disease manifestations, the Asia-Pacific region is well placed in studying disease outcomes and effects of novel therapies.