Background: Scleroderma is a chronic autoimmune multisystem disease. In skin lesions of scleroderma, skin thickening is the most common typical symptom. The study assessed the relationship between m-Rodnan score and cutaneous histopathology in scleroderma patients. Subjects and Methods: This cross-sectional descriptive survey assessed skin thickening based on the incremental skin approach and cutaneous histopathology in 11 scleroderma patients examined in the National Hospital of Dermatology and Venereology from May 2013 to November 2013. Results: Atrophic epidermis and dermis thickness increased with the degree of skin thickness. The reduction in the number and size of blood vessels and appendages as well as in inflaronmatory infiltrate simultaneously increased with skin thickness. Epidermal thickness, hair follicles thickness and epidermal pigmentation were found in almost all biopsy pieces. It was not abnormal in subcutis region. Conclusions: Cutaneous histopathology was consistent to skin thickness at cutting positions. However, this procedure was a penetrating test and required a lot of experience of histopathology to confirm the diagnosis. Therefore, it is necessary to take consideration in skin biopsy for scleroderma patients and able to use the m-Rodnan to substitute for cutaneous histopathology.