The 2022 European Society of Cardiology/European Respiratory Society guidelines define pulmonary hypertension (PH) as a resting mean pulmonary artery pressure (mPAP) > 20mmHg at right heart catheterization (RHC). Previously, patients with an mPAP between 21 and 24mmHg were classified in a "gray zone" of unclear clinical significance. What is the diagnostic performance of the main parameters used for PH screening in detecting patients with systemic sclerosis (SSc) with an mPAP of 21 to 24mmHg at RHC? Patients with SSc from the European Scleroderma Trials and Research (EUSTAR) database with available tricuspid annular plane systolic excursion (TAPSE), systolic PAP (sPAP), and mPAP data were included. Patients with mPAP 21 to 24mmHg and patients with mPAP≤ 20mmHg were considered for the analysis. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. TAPSE/sPAP was lower in the group of patients with SSc with mPAP 21 to 24mmHg than in the non-PH group (0.58 [0.46-0.72] vs0.69 [0.57-0.81] mm/mmHg, respectively; P< .01). No difference was found in other parameters between the two groups. Diffusing capacity of the lungs for carbon monoxide (Dlco)< 80%of the predicted value had the highest sensitivity (88.9%) and NPV (80%), but the lowest specificity (18.2%) and PPV (30.8%) in detecting patients with SSc with mPAP 21 to 24mmHg. TAPSE/sPAP< 0.55mm/mmHg had the highest specificity (78.9%), PPV (50%), and accuracy (68.1%); its NPV was 75.4%, and its sensitivity was 45.1%. Dlco< 80%of the predicted value is the parameter with the highest sensitivity and NPV in detecting patients with SSc with mPAP 21 to 24mmHg. TAPSE/sPAP< 0.55mm/mmHg has the highest specificity, PPV, and accuracy and, therefore, can be a useful additional parameter to decrease the number of unnecessary RHCs.