Cardiac involvement due to myocarditis in patients with systemic lupus erythematosus is rare, being a severe clinical finding within the spectrum of the disease and may be the first manifestation of it.A timely diagnosis is crucial for the prognosis of the disease, based on fundamental clinical, biochemical/serological and imaging criteria to establish aggressive treatment that allows the control of the disease and secondary complications.Recognition of anti-Ro antibody positivity in myocarditis has been described, but little studied, with uncertainty between a causal association. CASE REPORTThree clinical cases are presented, of patients who debuted with myocardial involvement and significant elevation of anti-Ro.The three patients were admitted with high activity of their disease, with cardiac magnetic resonance imaging with findings corresponding to an infiltrative process in the left ventricle consistent with lupus myocarditis, receiving treatment with pulsed methylprednisolone and cyclophosphamide. CONCLUSIONThere is a significant percentage of patients with SLE who are positive for antiRo antibodies and have manifestations of heart disease, including myocardial involvement.Therefore, it is necessary to expand the studies that allow the evaluation of causal associations to define risk groups and interventions that prevent the development of cardiac complications in this group of patients.