We reported a successful diagnosis of a 76-year-old male patient with systemic sclerosis. His main manifestation was edema, and the diagnosis was indefinite at the early stage. Symptomatic and supportive treatments were merely useful for temporary remission of the symptoms. Testing for serum related auto-antibodies showed that anti-nuclear antibody was positive after the aggravation of edema. Ultimately, the diagnosis of systemic sclerosis was established after skin biopsy. According to literature and our clinical experience, the clinical manifestations of systemic sclerosis were complicated and lack of specificity, so it was hard to diagnose at its early stage. We should take systemic sclerosis into consideration when we meet intractable cases with edema. More attention should be paid to skin lesion and serum related auto-antibodies testing in order to make the correct diagnosis of this disease as early as possible.