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Introduction Raynaud’s phenomenon (RP) is a frequent and burdensome vascular complication of systemic sclerosis (SSc). Pharmacological options have limited efficacy and tolerability, highlighting the need for alternative and complementary approaches. We conducted a systematic review to evaluate the effectiveness and quality of evidence for non-pharmacological interventions in SSc-RP.Material and Methods We searched MEDLINE, Embase, CINAHL, PsycINFO, and CENTRAL from inception to 10 April 2024, with additional citation searching of recent reviews in early 2025. Eligible studies were controlled trials with a comparator assessing non-pharmacological interventions in SSc-RP. Trials of mixed RP populations were excluded if SSc-specific subgroup results were unavailable. Duplicates were removed, and ineligible records flagged by automated filters were checked by the lead reviewer before exclusion. Screening, data extraction and risk of bias (Cochrane RoB 2) were conducted in duplicate.Results Of 635 records, 406 unique articles remained after deduplication. Following initial exclusions, 216 were assessed at title and abstract screening. Twenty-two proceeded to full-text review, and five randomised controlled trials (n = 177) were included. Silver fibre gloves (Liem 2023, n = 85) reduced RP burden overall but showed no difference between silver and normal gloves in the Raynaud’s Condition Score (RCS) (mean RCS 3.9 silver vs 3.9 normal, β= 0.067, 95% CI -0.006 to 0.19) or secondary outcomes. A 12-week exercise programme (Mitropoulos 2020, n = 32) improved RP pain compared with controls (p < 0.05). Acral CO2 hydrotherapy (Lange 2019, n = 24) produced acute improvements in digital perfusion, whereas hot water had no effect. Biofeedback (Freedman 1984, n = 24; Sporbeck 2012, n = 28) increased finger temperature in laboratory settings, with mixed effects on patient-reported outcomes. Risk of bias was low to some concerns overall, but self-reported outcomes in unblinded trials were at high risk. Heterogeneity in outcome measures and trial design precluded meta-analysis.Conclusions Evidence for non-pharmacological interventions in SSc-RP comes from only five small trials with heterogeneous methods. Benefits were inconsistent, often confined to laboratory or short-term outcomes, with variable effects on patient-reported measures. The diversity of intervention types and outcome reporting further limits comparability. Larger, well-designed studies using standardised, patient-centred endpoints are required to clarify the role of non-pharmacological approaches in SSc-RP management.