Objective. To investigate the Italian version of HAQ-DI (Health Assessment Questionnaire Disability Index) in systemic sclerosis (SSc). Methods. 121 SSc patients, satisfying ACR criteria for the classification of this disease and consecutively admitted to a tertiary Unit, were invited to participate to the study. The Italian version of HAQ-DI, as validated in rheumatoid arthritis, was administered to each of them. The relationships between this parameter and the following disease aspects: disease subset, wide extent of skin sclerosis, joint contractures, myopathy, active digital ulcers, were investigated. Results. HAQ-DI resulted to be 0.772 +/- 0.074 (mean +/- SE) Statistically significant differences in HAQ-DI scores were detected between patients with and respectively without wide extent of skin sclerosis (ie modified Rodnan skin score > 14) (1.158 +/- 0.176 vs 0.652 +/- 0.076; P< 0.001), joints contractures (0.839 +/- 0.076 vs 0.159 +/- 0.147; P< 0.001), myopathy (1.875 +/- 0.184 vs 0.656 +/- 0.071; P< 0.001), digital ulcers (1.047 +/- 0.135 vs 0.680 +/- 0.109; P= 0.006). Conclusions. Our data support the validity of the Italian version of HAQ-DI in SSc.