Substantial progress has been made in the past 10 years in the development and validation of outcome measures and refinement of trial methodology for systemic sclerosis (scleroderma, SSc). These advances in outcome measures have focused mostly on specific organ systems involved in SSc. Many of these new tools have been validated and subsequently adapted for use in multicenter clinical trials. Newer outcome measures in development are intended to more precisely quantify clinically meaningful change in specific organ systems, and some methods aim to assess overall disease burden in SSc. This review provides an update on currently used outcome measures in SSc with specific attention on newer tools and also describes methodology under development.