All available chest radiographs of 50 patients with progressive scleroderma have been freshly evaluated. In 28 cases (56%), pulmonary involvement was diagnosed; its type and severity was classified according to the specimen films of the ILO-U/C 1971 classification for pneumoconiosis. Serial observations in 27 patients spanning a period of one to 21 years have shown that the course of the disease in the lung is unpredictable. Rapid progress of fibrosis is, however, uncommon. Two radiological appearances in the thorax, which are not specific, but are found predominantly in scleroderma are: 1 an air oesophagram on the lateral thorax film (8 cases) and erosions of the upper rib margins (5 cases). The importance of radiological examination lies in the fact that it confirms the clinical diagnosis and that it may indicate the cause of an otherwise undiagnosed pulmonary fibrosis.