Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that can also affect the gastrointestinal tract (GIT). The GIT symptoms are common in SLE patients, occurring in up to 40%–50% of the patients and may involve almost any organ along the GIT. Abdominal pain is the most common symptom, and an important cause of this is lupus mesenteric vasculitis (LMV). LMV is a very rare presentation of SLE, and in some cases, can precede the typical manifestations of SLE. Here, we report such a case where a 30-year-old Saudi woman presented clinically with a 2-week abdominal pain and diarrhea; the patient had not previously been diagnosed with SLE. Laboratory investigations and abdomen computed tomography imaging confirmed the diagnosis of LMV. Early recognition of this condition and its proper management improve the outcome of this serious rare initial presentation of SLE.