Background: Systemic Sclerosis (SSc) is a chronic connective tissue disease with multiorgan involvement characterized by immune activation, inflammation, widespread smallvessel vasculopathy, progressive interstitial and vascular fibrosis in the skin and internal organs. The aim of our study was to present different clinical manifestations and the relevant radiological and laboratory investigations in patients with systemic sclerosis at Zagazig University Hospitals. Methods: This is a cross-sectional study that was carried out in Rheumatology and Rehabilitation department, Faculty of Medicine, Zagazig University Hospitals on 60 systemic sclerosis patients. These patients were subjected to detailed history taking, clinical and rheumatological examination, measuring the dermal skin thickness by the modified Rodnan skin score (mRSS), other clinical data and relevant investigation collected from patients’ files from follow up unit. Results: Our results revealed that the mean age was (44.50 ± 11.17) with disease durations range from 2 to 17 years with a median of 7 years, 54 patients were female (90%), 6 patients were male (10%). Skin tightness, puffy fingers and Raynaud phenomenon were present in all patients; mRSS (ranges 4-45). Antinuclear antibodies were positive in 100% of patients. Conclusion: This study has shown that all our patients with SSc had Anti-nuclear antibodies (ANA) positive, puffy fingers, skin tightness, Raynaud phenomenon and Worsening skin score. Also, limited cutaneous systemic sclerosis (lcSSc) was more common than diffuse cutaneous systemic sclerosis (dcSSc) in our SSc patients. Abnormal pulmonary function tests, interstitial lung disease (ILD), renal involvement and cardiac involvement are more common in dcSSc than lcSSc. Extensive clinical examination and investigations should be considered for early diagnosis and follow up of patients with SSc at Zagazig University Hospitals. Keywords: Systemic Sclerosis – modified Rodnan skin score – diffuse cutaneous systemic sclerosis - limited cutaneous systemic sclerosis