Objectives. This study aimed to describe the hematologic manifestations in adult patients with systemic lupus erythematosus (SLE) at the time of referral to a tertiary hospital in Indonesia. Materials and methods. We conducted a descriptive cross-sectional study of 103 consecutive patients diagnosed with SLE between 2020 and 2025 at Cipto Mangunkusumo Hospital, Indonesia. Demographic data, laboratory parameters, and prior medication history (corticosteroids/DMARDs) were extracted from electronic medical records. Anemia subtypes were classified morphologically using mean corpuscular volume (MCV) as a surrogate marker. Results. Of 103 patients, 99% were female, with a mean age of 32.46 years. A high prevalence of prior treatment was noted (91.3% on corticosteroids), and mycophenolate mofetil was the most prescribed DMARD. Hypocomplementemia was present in approximately two-thirds of patients. Anemia was observed in 97.1% (mean hemoglobin 8.84 g/dL), mainly anemia of chronic disease (54%). Leukopenia occurred in 54.4%, with lymphopenia in 94.6% of these cases. Thrombocytopenia was found in 18.4%, while thrombocytosis was rare (4.9%). Conclusion. Normocytic anemia was the most common hematologic manifestation in SLE, followed by lymphopenia and thrombocytopenia. These findings highlight the hematologic burden in Indonesian patients with SLE and underscore the necessity of monitoring blood counts in the context of high baseline corticosteroid exposure. © 2026, Amaltea Medical Publishing House. All rights reserved.