Aim To investigate the association between platelet-derived extracellular vesicles (PEV) and thrombosis events in patients with systemic lupus erythematosus (SLE). Methods A cross-sectional study was used to include 144 patients with SLE who were treated in the Department of Rheumatology and Immunology of Kailuan General Hospital from January 2019 to April 2022. The general situation, laboratory data and thrombotic event data of the selected patients were collected, and the plasma PEV was detected by flow cytometry. Plasma PEV levels between SLE patients with and without thrombotic events were compared, 144 SLE patients were further divided into high level PEV group and low level PEV group. The differences of thrombotic events and coagulation indicators were compared between different PEV level groups. Spearman correlation analysis was used to analyze the correlation between plasma PEV and coagulation indicators, multivariate Logistic regression analysis was used to analyze the correlation between plasma PEV and thrombotic events. Results PEV levels in the SLE patients with thrombosis events was significantly higher than those without thrombosis events (306.65 (150.8,2.75)/μL vs. 227.04 (178.3,1.36)/μL, P＜0.01). Compared with low level PEV group, the high level PEV group had more patients with thrombosis events (38.29% vs. 20.61%, P＜0.05).Spearman correlation analysis showed that PEV was positively correlated with plasma fibrinogen and D-dimer levels in SLE patients (P＜0.05). Multivariate Logistic regression analysis showed that PEV in peripheral blood was significantly correlated with total thrombotic events and arterial thrombotic events in SLE patients (OR＝1.8,2.23, P＜0.1,0.019), but there was no statistical difference between PEV and venous thrombotic events (P＞0.05). Conclusion The increased plasma PEV level in SLE patients with thrombotic events is related to hypercoagulability and thrombotic events, and may be an effective marker of arterial thrombotic events in SLE patients.