Introduction: Systemic sclerosis (SSc) is a multisystem autoimmune disease, with complex pathogenesis resulting in
obliterative vasculopathy, tissue injury, fibrosis, remodeling and atrophy. The neutrophil lymphocyte ratio (NLR) was
developed to provide easily measurable and readily available parameter reflecting the intensity of stress and systemic
inflammation in critically ill patients following shock, multiple traumas, major surgery, or sepsis. Aim of the work: to
evaluate NLR levels in patients with SSc and explore their clinical significance and their association with different organ
manifestations. Results: There was a significant increase in NLR in SSc patients who had cardiovascular or cardiorespiratory affection. Also NLR showed a significant positive correlation with both CRP and ESR, while it showed a significant negative correlation with serum albumin. Conclusion: NLR may serve as a promising marker for cardiorespiratory involvement in SSc patients. [Egypt J Rheumatology & Clinical Immunology, 2016; 4(1): 43-47]