Background: Skin changes are among the most common manifestations of Sjögren´s syndrome (SS). While being reported in literature, there is a substantial gap in existing literature regarding skin manifestations, as they are often overshadowed by sicca symptoms. Objectives: Explore the difference in skin changes between primary SS (pSS) and secondary SS (sSS), as well as the association between skin changes and organ involvement and disease duration. Additionally, an assessment of distribution and severity of skin manifestations. Materials and methods: Observational cross-sectional study included patients aged 18 years or older with diagnosis of pSS or sSS. Clinical data was collected from patient papers and digital medical records from clinical department, daily hospital and outpatient clinic of Department of Rheumatology and Clinical Immunology, Internal Clinic, University Hospital of Split, Croatia. Experimental group and control included 117 and 200 patients, respectively. For the analysis of difference in skin changes between pSS and sSS group, and association between skin changes and organ involvement and disease duration, Chi-square test of Independence was used. Results: Among the 317 study participants there was reported a total of 113 patients that exhibited skin changes. Most of the patients had a single type of skin manifestations, while 31 patients had two or more different skin changes. The most frequent skin changes in pSS patients were Raynaud phenomenon, rash and alopecia, while the most frequent manifestations in sSS were erythema, discoid lupus and Raynaud phenomenon. We noted a statistically significant difference in skin changes in pSS and sSS (30% vs 45%, p = 0.006). The relationship between the existence of organ involvement and skin changes was not statistically significant (p = 0.511). Similarly, we were not able to prove a statistically significant association between disease duration and manifestation of skin changes in patients with SS (p = 0.773). Conclusion: Our study revealed that skin changes are more frequent in patients with sSS compared to pSS. A wide spectrum of skin changes was observed. The most frequent cutaneous disorder in pSS was Raynaud phenomenon, while in sSS the most frequent was erythema. Regarding the association between skin changes and disease duration or organ involvement, we were not able to find an association that was statistically significant for either of the factors.