We conducted an open-label trial to evaluate whether simvastatin therapy was, or was not, associated in systemic sclerosis hypercholesterolemic patients (SSc-Ps) with beneficial changes in finger skin microvascular function. 13 females SSc-Ps and 15 females healthy control subjects (CSs), age-matched with SSc-Ps, underwent finger skin post-occlusive reactive hyperaemia (PORH), using laser Doppler flowmetry (LDF). This test was repeated in SSc-Ps after about 10 weeks of simvastatin (20 mg/day) therapy (ST). At baseline and after ST, finger skin vasomotion was evaluated using spectral Fourier analysis of the LDF tracings. Endothelin-1 and cholesterol serum levels were also determined in SSc-Ps at baseline and after ST. At baseline, SSc-Ps had significantly lower basal finger skin blood flow (basal flow) and PORH, compared to CSs (18.9 ± 11.7 PU vs. 28.5 ± 17.5 PU, 58.6 ± 31.0 PU vs. 93. 1 ± 37.3; P < 0.05). After ST, SSc-Ps had a significant increase in basal flow and PORH compared to baseline (42.7 ± 35.7 PU vs. 18.9 ± 11.7 PU, 111.0 ± 66.6 PU vs. 58.6 ± 31.0 PU, respectively; P < 0.05), as well as a significant reduction in endothelin-1, total- and LDL-cholesterol serum levels. After ST, SSc-Ps also showed a partially restored post-ischaemic amplification in finger skin blood flow oscillations within 0.06-0.6 Hz, related to myogenic vasomotion. This study showed that a short time period of ST in hypercholesterolemic SSc-Ps resulted in increased finger skin vasoreactivity and in partially restored post-ischaemic amplification of finger skin vasomotion, suggesting that ST affects positively finger skin microvascular dysfunction in SSc-Ps.