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Background Peristomal skin problems are a common complication in ostomy patients. This complication can impact treatment, increase healthcare costs and decrease the patient’s quality of life. The use of a valid, reliable and user-friendly measurement tool helps healthcare providers with objective follow-up and targeted treatment of peristomal skin problems. Several assessment tools have already been developed to assess peristomal skin problems, among which assessment tools Studio Alterazioni Cutanee Stomali (SACS) and Ostomy Skin Tool (OST) are the most common in the literature. A clear overview of the measurement properties of assessment tools SACS and OST can help health care providers in making an apt choice based on the follow-up and treatment of peristomal skin and provides a new incentive for the development of a ‘gold standard’ in assessment tools for peristomal skin in ostomy patients. Methods Databases Medline via PubMed, CINAHL via EBSCO, Embase, and CENTRAL were searched in March 2021. All studies that examined or described one or more psychometric characteristics of the assessment tools SACS and OST in adult patients were included. The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) Risk of Bias Checklist for patient-reported outcomes and the COSMIN Risk of Bias Tool for clinician-reported outcomes were used to assess the methodological quality of the included studies. The modified Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used to evaluate the quality of evidence for outcomes reported in this systematic review. Results After an extensive database search, over 4000 articles were found and screened by two independent researchers. After a thorough study selection process, four studies identifying two different psychometric properties, were included in this review. The quality level of the assessment instruments was very low for the psychometric property reliability and low for the content validity. The inter-rater reliability of the assessment instrument SACS was scored as sufficient in two studies and insufficient in one study. In the study concerning the assessment instrument OST, investigation of the inter-rater reliability did not result in an unambiguous outcome. The content validity was only scored in studies concerning the assessment instrument SACS on the basis of items such as relevance, completeness and clarity. The studies scored satisfactory for relevance and completeness in contrast to clarity where the score was indeterminate. The usability of the assessment tool SACS was surveyed and found to be convenient. Conclusion The psychometric properties of peristomal skin assessment instruments, SACS and OST, have not been sufficiently studied. The overall assessment for reliability and content validity was variable or indeterminate. More research is needed to further investigate the psychometric characteristics of the current assessment instruments SACS and OST for the assessment of peristomal skin disorders.