The 2016 European League against Rheumatism (EULAR) recommendations for the treatment of systemic sclerosis (SSc) were updated to address new therapeutic questions. The task force, consisting of 32 SSc clinical experts, 2 patients, a clinical epidemiologist, and 2 research fellows, used a Delphi approach to select 46 clinical questions from 170 submitted by EUSTAR centers. Systematic literature reviews were conducted for each question, and 16 recommendations were developed based on available evidence and consensus among experts and patients. The new recommendations include phosphodiesterase type 5 (PDE-5) inhibitors for Raynaud’s phenomenon (RP) and digital ulcers (DUs), endothelin receptor antagonists, prostacyclin analogues, and PDE-5 inhibitors for pulmonary arterial hypertension (PAH). Fluoxetine is recommended for RP, and haematopoietic stem cell transplantation (HSCT) is recommended for selected patients with rapidly progressive SSc. The recommendations also address other treatments and provide suggestions for future research. These updated recommendations aim to guide rheumatologists in managing SSc patients more effectively.The 2016 European League against Rheumatism (EULAR) recommendations for the treatment of systemic sclerosis (SSc) were updated to address new therapeutic questions. The task force, consisting of 32 SSc clinical experts, 2 patients, a clinical epidemiologist, and 2 research fellows, used a Delphi approach to select 46 clinical questions from 170 submitted by EUSTAR centers. Systematic literature reviews were conducted for each question, and 16 recommendations were developed based on available evidence and consensus among experts and patients. The new recommendations include phosphodiesterase type 5 (PDE-5) inhibitors for Raynaud’s phenomenon (RP) and digital ulcers (DUs), endothelin receptor antagonists, prostacyclin analogues, and PDE-5 inhibitors for pulmonary arterial hypertension (PAH). Fluoxetine is recommended for RP, and haematopoietic stem cell transplantation (HSCT) is recommended for selected patients with rapidly progressive SSc. The recommendations also address other treatments and provide suggestions for future research. These updated recommendations aim to guide rheumatologists in managing SSc patients more effectively.