In patients with systemic sclerosis, two main subsets of vascular acrosyndromes can be found: Raynaud's phenomenon and digital ulcerations. A severe Raynaud's phenomenon is found in almost every patient with systemic sclerosis. Most often, it is the first sign announcing the emergence of the disease and the hypothesis of subclinical scleroderma should be evaluated in every patient with apparently isolated Raynaud's phenomenon. Digital ulcerations can show several clinical aspects: ischemic micro-ulcerations and pitting scars of the finger tips, nailbed and nailfold lesions and digital necrosis, but also chronic ulcerations of the dorsal skin surface of the finger joints and ulcerated dermal calcifications, the origin of which is not only ischemic. First line treatment of such acro-syndromes is based upon cold avoidance and calcium-blocking agents. In the most severe cases, hospitalization in specialized centers is required, where customized physiotherapy and perfusions of prostaglandins or dextrans will be performed.