Background: Systemic sclerosis is an autoimmune connective tissue disorder which is characterised by cutaneous and internal organ fibrosis. Raynaud’s phenomenon is the earliest feature and may precede the onset of the disease by months to years. The heart, lungs, gastrointestinal tract, kidneys and other organs may be involved. Our aim was to evaluate skin thickness and echogenicity in systemic sclerosis patients by ultrasound and compare it with the healthy age and sex matched controls. Method: Our study included 15 successively admitted patients (14 females and 1 male) with systemic sclerosis and 15 healthy age and sex matched controls. All the patients met the ACR criteria of diagnosis. The age range of the patients was 25-55 years. The disease duration ranged from 1-8 years. A complete history and physical examination was done for each patient. Skin thickness and echogenicity were measured by a 20MHz ultrasound probe at 6 different anatomical sites which was compared with that of the controls. Result: Skin thickness was more in systemic sclerosis patients (significant p value) as compared to controls, and echogenicity was inversely proportional to the skin thickness. Conclusion: Skin ultrasonography is a noninvasive method which can reflect the severity of skin involvement and periodic assessment of skin thickness and echogenicity can help to monitor the progression of the disease.