A population based study of the occurrence of scleroderma was carried out on the 4.1 million adult residents of the West Midlands Region. Seven separate sources were used to obtain cases. This first epidemiological study of scleroderma in the UK suggests prevalence rates of 13 and 48 per million in males and females respectively, with annual incidence rates of 1 and 6 per million. The peak age of onset is between 45 and 54 but new cases continue to arise even during the eighth decade. There is a pronounced female excess, with a ratio of 6:1, this excess being particularly marked in those under 45. It is difficult to assess the completeness of notification and thus the estimates should be considered as minimum. There are, however, suggestions in these data that the completeness of recording was high.