The observation of anti-C1q antibodies (C1qAb) in patients with various autoimmune diseases has led to the establishment of a strong correlation between these antibodies and renal involvement in patients with systemic lupus erythematosus (SLE). The measurement of anti C1q antibodies requires detailed insight in the reactivity of C1q with immune complexes and the methods to detect C1q as an antigen by solid phase assays. In this overview we describe the pitfulls of the anti C1qAb assay and its use in the measurement of C1qAb. Further we discuss the relevance of C1qAb in the pathogenesis of SLE and especially in relation to lupus nephritis.