<h3>Background</h3> Systemic Lupus Erythematosus (SLE) is a chronic multisystemic autoimmune pathology of unknown etiology with a variable course and a predilection for women of reproductive age. Chronic activity and flares of disease activity are correlated with greater damage accrual and mortality. Mortality and health-related quality of life (HR-QoL) are higher in SLE patients when compared to general population. Damage accrual, duration of the disease, disease activity and involvement of specific organ systems, might relate to worse HR-QoL in SLE. A worse perception of health is associated with a higher damage accrual over time. <h3>Methods</h3> A retrospective cohort of SLE patients (ACR 1997 or SLICC 2012 classification criteria), followed for at least 1 year, between 2015 and 2017 in a specialized center was analyzed. Activity evaluated by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), damage accrual by SLICC/ACR damage index (SDI) and HR-QoL by EQ-5D were measured. Bivariate analysis through chi squared and U Mann Whitney Multivariate analysis was performed by logistic regression to adjust for significant associations. Statistical analysis for related samples was evaluated with Mc. Nemar test. <h3>Results</h3> We analyzed 400 Colombian patients. Baseline median age was 49 years (15 IQR) with median age at diagnosis and disease duration of 37 years (17 IQR) and 9 years (13 IQR) respectively. There were 94% female patients and 17.3% late onset SLE. Most frequent clinical manifestations were hematological (82.8%), mucocutaneous (75.3%) and nephritis (33.8%). Only 4.5% had neurological involvement. The mean SLEDAI were 1.18 and 0.65 at first and second measurement respectively, in the first measurement 97.1% of the patients had a SLEDAI ≤4. The mean SDI was 0.7275 at first measurement and 0.985 at the second measurement. Although SDI was associated to various dimensions of HR-QoL measured by ED-5D, disease activity was not related (See table 1). <h3>Conclusions</h3> In SLE Colombian patients with a stablished disease and an altered HR-QoL, low disease activity is not related with HR-QoL when measured by EQ-5d. In the present study, it is highlighted that while disease activity decreases, damage increases. Damage accrual has a relation with HR-QoL in the short term. The impact and correlation must be better defined in a long-term follow-up. The associated effect on HRQOL emphasizes the need for strategies to reduce the risk of cumulative organ damage.