Circulating autoantibodies against ribosomal proteins characterise a subset of patients with systemic lupus erythematosus. Following the identification of three phosphorylated proteins as the main ribosomal autoantigens recognised by these autoantibodies, several studies have been carried out in the last decade to set up a reliable and sensitive method of detecting anti-ribosome autoantibodies and disclosing their possible clinical relevance in the diagnosis and monitoring of symptoms and signs of the disease. Although a number of clinical associations have been proposed, contrasting results have emerged from these investigations. This review analyses the methodological problems linked with the various techniques used to detect anti-ribosome antibodies and provides a critical update of the clinical associations described in lupus patients to date.