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Introduction Patients with systemic sclerosis (SSc) often complain of dysphagia due to esophageal dysmotility or oropharyngeal factors. Swallowing difficulties can lead to malnutrition and serious complications if not recognized early. The purpose of this study is to assess dysphagia using the Eating Assessment Tool-10 (EAT-10) in Greek patients with SSc and assess key factors that contribute to dysphagia.Material and Methods The validated Greek version of the EAT-10 questionnaire was used. The tool consists of 10 items, each corresponding to 5 levels of difficulty ranging from 0 (‘no problem’) to 4 (‘severe problem’). The total score ranges from 0 to 40, and a score greater than or equal to 3 is considered abnormal, indicating possible dysphagia. Demographic data was collected and anthropometric measures were recorded according to standardized procedures by experienced dietitians. We then aimed to identify factors that contribute to dysphagia. For categorical comparisons, contingency tables with Fisher’s exact test were applied while continuous variables were compared using Wilcoxon rank-sum or Kruskal–Wallis tests where appropriate. Statistical analyses were performed using RStudio software [version 4.3.2 (2023-10-31), R Foundation for Statistical Computing, Vienna, Austria]. A p-value <0.05 was considered as statistically significant.Results A total of 21 patients with SSc completed the assessment. The majority were female (90.5%), with a mean age and standard deviation (SD) of 54.3 ± 13.8 and mean disease duration of 13.9 ± 10.2 years. The EAT-10 tool identified dysphagia in 76.2% of our sample. Dysphagia prevalence was higher in patients with gastroesophageal reflux (GERD) compared to those without (92.3% vs 50.0%, p=0.047, OR=10.4). Similarly, dysphagia differed in body mass index (BMI) categories (underweight 83%, normal weight 100%, overweight 43%, p=0.025). No significant differences were observed in age (p=0.56), C-reactive protein (p=0.67), serum albumin (p=0.72) and corticosteroid use (p=1).Conclusions Our findings confirm that dysphagia is highly prevalent among Greek patients with SSc, affecting 76.2% of our sample. The association of dysphagia with GERD reflects the frequent co-existence of reflux and esophageal mobility issues. The observation that underweight and normoweight patients had high dysphagia prevalence might reflect reverse causation since dysphagia contributes to weight loss. These results highlight the need for dysphagia screening among SSc patients and a multidisciplinary approach involving rheumatologists, dietitians and gastroenterologists in order to avoid malnutrition and other complications.