Objective-To estimate the future risk and time trends of newly diagnosed venous thromboembolism (VTE) in individuals with incident systemic lupus erythematosus (SLE) in the general population.Methods-Using a population-based database that includes all residents of British Columbia, Canada we conducted a study cohort of all patients with incident SLE and up to 10 age-, sex-, and entry-time-matched individuals from the general population. We compared incidence rates of pulmonary embolism (PE), deep venous thrombosis (DVT) and VTE between the two groups according to SLE disease duration. We calculated hazards ratios (HR), adjusting for confounders.Results-Among 4,863 individuals with SLE (86% female, mean age 48.9 years), the incidence rates (IRs) of PE, DVT, and VTE were 2.58, 3.33, and 5.32 per 1000 person-years, respectively, whereas the corresponding rates in the comparison cohort were 0.67, 0.57, and 1.11 per 1000 person-years. Compared with non-SLE individuals, the multivariable HRs among SLE patients were 3.04 (95% CI, 2.08-4.45), 4.46 (95% CI, 3.11-6.41) and 3.55 (95% CI, 2.69-4.69), respectively. The age-, sex-, and entry time-matched HRs for PE, DVT and VTE were highest Contributors: JAA-Z secured the funding source, and contributed to study conception, study design, data analysis/interpretation, and critical review of the manuscript. KV and MDV contributed to data analysis/interpretation and drafted the manuscript. ES contributed to data analysis and manuscript preparation. HKC secured some of the funding sources, and contributed to study conception/design, data analysis/interpretation, and critical review of the manuscript. Conclusion-These findings provide population-based evidence that patients with SLE have a substantially increased risk of VTE, especially in the first year after SLE diagnosis. Awareness and increased vigilance of this potentially fatal, but preventable, complication is recommended.