Introduction: Systemic sclerosis (SSc) is a generalized disorder ofconnective tissue characterized by thickening and fibrosis of the skin and by distinctive forms of involvement of internal organs. Renal involvement and systemic vascular damage have been shown to significantly affect prognosis. It is often difficult to assess damage to the renal and systemic vasculature in systemic sclerosis patients. Assay for microalbuminuria is thought to detect scleroderma renal disease at an early stage, to assess systemic vasculopathy and to predict increased morbidity.Aim of the work: The aim of the work is to evaluate microalbuminuriain scleroderma patients as an indicator of early renal involvement andsystemic vasculopathy and to correlate the quantity of microalbuminuria with the various clinical, laboratory and radiological disease parameters and with the severity of organ systems’ damage as assessed by Scleroderma Assessment Questionnaire (SAQ).Patients and methods: The study included forty patients with SScattending the Rheumatology and Rehabilitation department of CairoUniversity, diagnosed according to the American College of Rheumatology criteria, excluding those with associated arterial hypertension, diabetes mellitus, cardiovascular diseases including pulmonary hypertension, heart failure, preexisting renal disease and urinary tract infection. Database from every patient included full history taking, thorough clinical examination, relevant laboratory tests including total urinary proteins, albumin/creatinine ratio and creatinine clearance and assessment of the severity of organsystems’ damage by Scleroderma Assessment Questionnaire.Results: Eight patients (20%) were positive for microalbuminuria.Nine patients (22.5%) had decreased creatinine clearance. The meanalbumin/creatinine ratio was significantly higher among patients withdiffuse SSc as compared to those with limited SSc and SSc sinescleroderma. Albumin/creatinine ratio significantly and positively correlated with telangiectasia and modified Rodnan’s skin score. There was a significant but negative correlation between albumin/creatinine ratio and each of interincisor distance and pleurisy. Albumin/creatinine ratio positively correlated with the Index of Musculoskeletal Status and the Index of Disease Status of Scleroderma Assessment Questionnaire.Conclusion: Assay for microalbuminuria is a sensitive tool for earlydetection of renal involvement before the development of overt clinical disease and reduction of GFR. It is not merely an indicator of renal affection III but it is also a marker of systemic vascular insult. Moreover, it is a reliable predictor of increased morbidity and poor prognosis.