We report the case of a 55-year old woman who was thought to have systemic lupus erythematosus (SLE) for more than 13 years before Crohn’s colitis was correctly diagnosed. The differentiation of Crohn’s disease from SLE may be difficult, as illustrated by our case. Gastrointestinal symptoms, laboratory studies, and radiographic findings may appear similar between the two diseases. The correct diagnosis has important treatment and prognostic implications. © 1995 Southern Medical Association.