OBJECTIVES: The aim of the study was to investigate whether there are common problems that occur when translating (and linguistically validating) PRO measures for use in Slavic countries. METHODS: Past translation projects were selected, which had involved the translation of different PRO measures into two or more Slavic languages. All of the projects employed a standard methodology: 2 forward translations, reconciliation, 2 back translations and back translation review. All of the projects also used linguistic validation interviews with either patients or lay people, depending on the target population, or a clinician review. The documentation of each project was thoroughly examined to identify what the key issues were when translating PRO measures into Slavic languages. RESULTS: Translation issues were mainly linguistic in nature and in most cases were highlighted during the back translation step. Issues included: the omission of articles and possessive pronouns when Slavic languages are back-translated into English; more literal translations are often required to convey figurative ideas in English; Slavic translations cannot always be as concise as the source English and this often leads to the translation being more explanatory in nature; when compared to English, Slavic languages do not have such a wide array of synonymous terms, especially when describing graded emotional states - where English terms do not have a direct [Slavic] equivalent, it is essential to explain the intended meaning of the item in question to ensure that the final translation does not deviate conceptually from the source text. CONCLUSIONS: When translating and linguistically validating PRO measures for use in Slavic countries it is important to be aware of the commonality found between the languages in this language group and to ensure that care is taken to maintain the conceptual equivalence between the source text and the Slavic translation.