Systemic sclerosis is an autoimmune disease characterized by endothelial cell injury, fibroblast activation and immunological aberrations. Generalized form of the disease involves skin and other organs. Progressive sclerodermatous type cGVHD is the difficult type to treat. Immunosuppressors are the most commonly used treatment regimens. Topical silicone gel sheet (SGS) were first used in the treatment of burn wound and following their initial successes have begun to be used in the treatment of hypertrophic scars and keloids. To best of our knowledge, this is the first patient with extensive sclerodermatous type cGVHD in whom SGS was applied on to the skin of the antecubital region. After a six months application of SGS, the skin of this region was remarkably soft and thick compared to other regions of the arm. The result indicate that SGS may be an useful tool for the treatment of extensive sclerodermatous type cGVHD.