The occurrence of acute renal-vein thrombosis (RVT) is a possible but rarely described complication of systemic lupus erythematosus (SLE). It has not been reported to occur as the initial presentation in lupus patients. We hereby describe a 17-year-old female with renal vein thrombosis due to SLE on initial presentation. The patient presented with flank pain, flank tenderness and fever. She was treated with anticoagulation, the mainstay of therapy for RVT in general. With appropriate diagnosis and anticoagulation therapy, our patient had a benign course during 6 months of follow-up.