Gastrointestinal transit times were measured in 12 patients with progressive systemic sclerosis. The CREST syndrome (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) was found in all patients. None of the patients reported complaints referable to specific gastric, small intestinal, or colonic involvement. The patient group had an increased mean gastric emptying time of 99mTc-labeled cellulose fiber when compared with 16 healthy controls [1.17 (0.89-1.38) hr [median (range)] vs 0.84 (0.56-1.88) hr; P less than 0.02], whereas mean gastric emptying time of 2- to 3-mm 111In-labeled plastic particles was unaffected [1.86 (0.99-2.74) hr vs 1.50 (0.92-2.51) hr; NS]. No difference was observed in mean small intestinal transit time of cellulose fiber [4.33 (0.50-7.04) hr vs 3.74 (2.09-7.59) hr; NS] or plastic particles [4.21 (2.00-6.25) hr vs 3.53 (1.50-6.70) hr; NS] between patients and controls. The patient group had an increased mean colonic transit time of plastic particles [47 (24-116) hr vs 29 (18-46) hr; P less than 0.01]. These findings suggest that asymptomatic delay in gastric emptying and colonic transit is frequent in patients with progressive systemic sclerosis.