Systemic lupus erythematosus (SLE) is the most common autoimmune disease. Kidney involvement is one of the most frequent and serious organ manifestations of SLE. At least over 50% patients with SLE have renal involvement. Class V lupus nephritis, also called membranous lupus nephritis, accounts for approximately 8%-20% of lupus nephritis as confirmed by renal biopsy. Currently, evidence-based recommendations for treatment of calss V lupus nephritis are lacking. Non-immunosuppressive treatment should be instituted early in all patients mainly for decreasing proteinuria, controlling blood pressure, lowering serum lipids, and anti-coagulation, among which blockade of the renin-angiotensin system with ACE inhibitors or ARBs is an important consideration. If class V lupus nephritis is associated with clinically relevant severe proteinuria, renal insufficiency, or failure to respond to the non-immunosuppressive treatment, immunosuppressive treatment is indicated, including glucocorticoids combined with azathioprine, alkylating agents, calcineurin inhibitors, or mycophenolate mofitil. Large-scale clinical trials are still needed for the options and efficacy of immunosuppressive regimens.