Systemic sclerosis (SSc) is a connective tissue disease characterized by progressive fibrosis of the skin and internal organs. Assessment of skin involvement is of significant importance for establishing patient prognosis and monitoring progression of the disease. Modified Rodnan skin score (mRSS) has been generally accepted as a relatively simple and reliable method of skin assessment in patients with SSc. However, due to the subjective character, proper evaluation of the mRSS requires appropriate clinical experience. This review presents practical aspects of how mRSS should be performed.