Background: Patients with systemic lupus erythematosus (SLE) and anti-Ro+ antibody frequently pose a diagnostic and therapeutic challenge for the specialist, as they frequently present sicca syndrome, overlapping with Sj & ouml;gren's syndrome (SS). To date, the clinical and prognostic variability that this antibody confers on SLE patients is not well characterized. Objectives: To investigate the possible clinical, analytical, therapeutic and prognostic implications of antiRo antibody in SLE. Furthermore, we analyzed the possible implications of the expressed anti-Ro profile (subunit 52, 60 or both) on the disease phenotype. Methods: The medical records of patients with anti-Ro+ and-SLE, primary SS and SLE/SS overlap have been reviewed. Results: Anti-Ro+ SLE presents less arthritis, low C4, expression of DNA Crithidia and need for bolus corticosteroids than anti-Ro- SLE, but more xerophthalmia, xerostomia, expression of anti-La, anti-cyclic citrullinated peptide and overlap with other rheumatological entities. Anti-Ro+SLE and the overlap group behave similarly for multiple variables. SS group shows a higher expression of (32-microglobulin compared to the overlap group. Anti-Ro52+ patients associate more Raynaud's phenomenon than anti-Ro60+ patients. The latter express more lupus anticoagulant and antiphospholipid antibodies than the group with both subunits. Conclusions: The presence of anti-Ro+ in patients with SLE provides clinical and analytical differences compared to patients with anti-Ro- SLE and SLE/SS. anti-Ro+ SLE and the overlap group behave similarly, but present differential characteristics that postulate them as separate phenotypes of the disease. The different serological profiles of anti-Ro confer specific clinical and analytical characteristics in patients with SLE and SS. (c) 2025 Sociedad Espanola de Reumatolog & imath;a (SER), Colegio Mexicano de Reumatolog & imath;a (CMR) y Elsevier Espana, S.L.U. All rights are reserved, including those for text and data mining, AI training, and similar technologies.