Dermatitis herpetiformis (DH) is characterized by neutrophil-driven blister formation dependent on cutaneous IgA deposition targeting TG3 antibodies. Circulating TG3-specific IgA antibodies are found in the majority of patients and approximately 75% of DH patients exhibit small bowel villous atrophy. The study aimed to investigate whether serum calprotectin (sCP), a neutrophil-derived inflammatory protein, could serve as a minimally invasive biomarker in diagnostics, follow-up, or assessing the presence of enteropathy in DH. The study included 14 untreated DH patients sampled at diagnosis and after 12 months on a gluten-free diet. Controls included untreated CeD patients (n=9), dermatological (n=34) and healthy controls (n=31). sCP concentrations and TG3 antibody levels were measured using ELISA. Small bowel mucosal morphology was determined by villous height-to-crypt depth ratio. At diagnosis, sCP levels did not differ between DH patients and controls and did not change during the follow-up. However, the sCP levels in DH correlated strongly with TG3 autoantibody levels (Pearson’s r=0.72, p=0.0038). Moreover, sCP predicted the speed of serological recovery; patients with lower baseline sCP achieved negative TG3 antibody seroconversion significantly faster than those with higher sCP levels (p=0.0013). Untreated DH patients with villous atrophy exhibited significantly higher sCP levels compared to those with normal mucosal architecture (mean: 1684 with vs. 973 without, p=0.021) while the opposite was detected in untreated CeD (mean: 819 with vs. 1315 without, p = 0.0397). In conclusion, sCP holds clinical promise as a minimally invasive biomarker for small bowel enteropathy in DH. The inverse sCP-atrophy relationship compared to CeD likely reflects fundamental differences neutrophil-associated mucosal immune responses and tissue remodelling. Furthermore, sCP might have potential to identify patients who TG3 antibody seroconversion early. Although negative TG3 antibodies does not necessarily equal to clinical recovery, the clear connection between diagnostics sCP and recovery speed provides a valuable direction for future research.