OBJECTIVES: Understand physician and patient perspectives with respect to patient involvement in treatment decisions and the perceived impact on patient outcomes in SLE. METHODS: This was a cross-sectional U.S survey of independent (geographically diverse) samples of practicing rheumatologists (with >3yrs of SLE experience) and adult SLE patients recruited from panels & clinics. Study participants completed a one-time web-survey covering perceptions of SLE-management, patient-physician-communication and expectations. Analysis included descriptive statistics and subgroup comparisons using chi-square and t-tests. RESULTS: 218 physicians (Caucasian 68%; African-American <1%; mean age 49ys) and 166 patients (Caucasian 61%; African-American 30%; mean-age 47ys) completed the survey as of April 2012. Overall, 61% and 76% of physicians and patients, respectively, reported high-patient-involvement (often/very often) in treatment decisions. Physicians and patients in high-patient-involvement groups (vs. low-patient-involvement groups):  a) reported greater satisfaction with physician-patient interactions (physicians: 8.1vs.7.5,p=0.12; patients: 9.1vs.6.3,p<0.001) and b) were more likely to discuss daily impacts all/most of the time (physicians:70%vs.54%,p=0.002; patients:76%vs.55%,p=0.002). Among physicians, no differences were observed between high-vs.-low-patient-involvement groups in being hopeful about patient future (95%vs.95%) and ratings of their bedside manner (78%vs.75% warm/very-warm); whereas, among patients in high-vs.-low-involvement groups, these ratings were 82%vs.67% (p<0.001) and 72%vs.41% (p<0.001), respectively. More patients in high-involvement group reported not missing a dose/appointment since treatment-initiation (59%vs.50%,p=0.36) and setting clear goals with their physicians (78%vs.26%,p=0.003); more high-involvement patients also reported their SLE had a high/very-high impact on their QOL (66%vs.53%,p =0.01). Those who believe that patient involvement in treatment decisions improves outcomes ‘a lot’ differed significantly (p<0.03) in high-vs.-low-patient-involvement groups among physicians (57%vs.0%) and patients (58%vs.35%). CONCLUSIONS: Rheumatologists and SLE-patients reporting high-patient-involvement in treatment related decisions were relatively more satisfied with their interactions and had a positive outlook on future and outcomes. Further research is warranted to assess factors influencing these attitudes and their impact on patient outcomes in clinical practice.