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Objectives Gastrointestinal (GI) involvement is almost universal in patients with systemic sclerosis (SSc). Our aim was to benchmark and describe GI involvement in SSc, exploring potential clinical associations including in patients with myositis overlap.Design Retrospective, cross-sectional study.Setting Patients attending a UK tertiary referral centre for SSc in 2024.Participants Adult (n=149) patients with an established clinical diagnosis of SSc (excluding a very early diagnosis of SSc). Subgroup analysis of those with myositis overlap.Interventions None; observational study design, including description of prescribed treatments.Main outcome measures Relevant patient and disease-related data were obtained from electronic patient record review. We developed a simple clinician-assessed score to assess GI symptoms burden: 0 (‘none’), 1 (‘effectively managed’) or 2 (‘unmanaged’). Descriptive statistics and appropriate testing were used to describe the data.Results We included 149 patients (female, 86%), most (71%) had limited cutaneous SSc and 13% had myositis. Median (IQR) SSc-disease duration was 11.1 (43.0) years. Over half (61%) had current GI symptoms (score 1 or 2); 43% had unmanaged symptoms (score 2). The most common symptoms were reflux (32%) and dysphagia (28%). Proton pump inhibitor use was high (81%). Both anticentromere (p=<0.001) and anti-Scl70 (p=0.01) antibodies were associated with GI symptoms, but not anti-RNA polymerase (p=0.78). No statistically significant association was seen between GI involvement and interstitial lung disease (p=0.06), pulmonary hypertension (p=0.42) or digital ulcers (p=0.84). No association was observed between GI involvement and disease duration (p=0.44). Over half (63%) with myositis overlap had GI involvement.Conclusions GI involvement is common and often symptomatic in SSc, but not over-represented in patients with myositis overlap. Research is needed to understand natural history, pathobiology and heterogeneity, including early intervention strategies.Trial registration number NCA reference: 25HIP20.