Background <p>Laryngeal involvement in scleroderma may include nonspecific findings associated with laryngopharyngeal reflux, scleroderma-related lesions of the vocal folds, and less frequently, vocal cord palsy or cricoarytenoid joint fixation.</p> Case presentation <p>We report the case of a patient with systemic sclerosis (SCL), followed in our rheumatology department, who developed hoarseness and dysphonia. Ear, nose, and throat examination revealed bilateral vocal cord bowing with a persistent glottic gap during phonation, along with findings consistent with laryngopharyngeal reflux. Laryngoscopic evaluation confirmed laryngeal involvement related to SCL in addition to laryngopharyngeal reflux disease. During follow-up, the patient demonstrated clinical improvement after four weeks of dietary modifications and treatment with oral proton pump inhibitors.</p> Literature review <p>A literature review identified only eight relevant articles, underscoring the rarity of laryngeal involvement in scleroderma. Reported symptoms included voice changes, stridor, and dysphagia, while endoscopic findings ranged from vocal fold atrophy and immobility to laryngeal hypertrophy and signs of reflux. Histological examination frequently revealed chronic inflammation and increased collagen deposition. Treatment strategies included corticosteroids, tracheotomy, lesion excision, and vocal rehabilitation exercises.</p> Conclusion <p>Laryngeal involvement in scleroderma is rare. Endoscopic evaluation plays a key role in identifying the cause of hoarseness in patients with scleroderma. Management of laryngopharyngeal reflux and voice rehabilitation contributes to improved clinical outcomes.</p> Graphical Abstract <p></p>