Background: Previous studies have already proven high rates of common mental disorders in Syrian refugees. Nevertheless, little is known about the patterns of somatic distress among this refugee population. For this reason, we aim to examine the prevalence, co-occurrence and risk factors of somatic distress among Syrian refugees in Germany.Methods: The study design was a register-based cross-sectional survey of 116 adult Syrian refugees with residence permission in Germany. The survey consisted of information on sociodemographic and migration-specific characteristics, health care utilization, traumatic life events, acculturative stress (Barcelona Immigration Stress Scale – BISS; subscales: perceived discrimination, intercultural contact stress, homesickness, and general psychosocial stress) and self-reported outcomes of somatic distress (Patient Health Questionnaire 15), depression (Patient Health Questionnaire – 9), generalized anxiety disorder (GAD – 7), and post-traumatic symptoms (Essen Trauma Inventory).Results: Almost half of respondents (49.1%) were identified as being at risk of somatic distress (PHQ-15 score ≥ 6), and even 24.1% being bothered by moderate to severe levels of somatic distress (PHQ-15 score ≥ 10). The most robust associations with somatic distress were found for female gender, the amount of health care utilization, multiple trauma exposures, general psychosocial stress, self-reported depression and anxiety symptoms. High comorbidities with somatic distress were shown for all common mental disorders studied.Conclusions: To date, there was no data on the specific patterns of somatic distress among Syrian refugees in Germany. The presented study reveals a significant risk of somatic distress among this displaced population and highlights implications for policy and health care providers.