Background: Lupus nephritis (LN) is a serious manifestation of systemic lupus erythematosus. Induction immunosuppression can include high dose cyclophosphamide (NIH protocol), low dose cyclophosphamide (Euro-lupus protocol) or mycophenolate mofetil (MMF). We aimed to assess the efficacy and safety of the 3 induction regimens in Egyptian patients with LN. Patients and methods: A cohort of 90 patients with LN was divided into 3 groups according to their treatment regimen: NIH protocol, Euro-lupus protocol, and MMF-based therapy groups. Therapy response was assessed at 6 months and was divided into either: complete remission (CR), partial remission (PR), or lack of response. Results: MMF-based therapy achieved significantly higher complete remission rate (74.3% vs. 51.7% in NIH, 42.3% in Euro-lupus groups; p=0.03). There was no significant difference between the 3 groups in overall remission (65.5 % in NIH, 69.3% in Eurolupus, 85.7% in the MMF groups; p=0.14), or in partial remission. The six-month survival did not differ between the 3 groups (93.1% in NIH, 96.2% in Euro-lupus and 100% in MMF groups; p=0.3). Infection rates were highest among the NIH followed by EuroLupus and then MMF groups (p<0.05). Diarrhea was more common among the MMF group (p=0.02). Conclusion: MMF can be prescribed as a first line therapeutic option in Egyptian patients with lupus nephritis, while considering low dose cyclophosphamide therapy as an alternative option. Our study is the first Egyptian study to demonstrate a head-to-head comparison between the 3 most commonly used induction regimens for lupus nephritis patients.