Background: Systemic lupus erythematosus is a condition where the immune system attacks various tissues and organs, affecting commonly women between the ages of 15 to 44. It is caused by genetics or environmental factors. A critical factor in the diagnosis by antinuclear antibodies at a level of ≥1:80. Objective: To assess the disease activity and identification of antinuclear antibody patterns and titer on Hep-2 cells with immunological markers. Methods: This was a case-control study conducted at Baghdad Teaching Hospital/Medical City between January 25, 2024, to April 25, 2024. 60 SLE patients were contrasted with 60 healthy controls. The American College of Rheumatology SLE criteria were used to make the diagnosis. Results: SLE patients had a mean age of 32.12±10.54 years, while controls had a mean age of 31.37±10.65 years (P=0.699). positive family history represents 15.0 % while negative family history of SLE patients is 85.0%. The mean disease duration was 5.25±4.77 years. The disease activity index (SLEDI) was (27.80 ±10.40). The most common patterns of Antinuclear Antibodies (ANA) are speckled (56.7%), homogeneous (26.7%), peripheral (1.7%), mixed (3.3%), and negative (11.7%) patterns. Conclusion: Antinuclear antibodies are considered the gold standard diagnostic test. A few healthy individuals display speckled patterns at a ratio of 1:40. The disease activity no significant with pattern.