OBJECTIVES: To assess Canadian patient preferences and estimate willingness to pay for symptoms relief for gastroesophageal reflux disease (GERD) treatment. METHODS: The study was a cross-sectional design, recruiting patients enrolled in a multi-centre clinical trial from 17 Canadian clinical sites.  Preferences and willingness to pay were estimated using a discrete choice experiment (DCE) informed by focus groups and clinical literature.  The experimental design considered orthogonality, balance and efficiency.  The pen-and-paper-administered DCE survey consisted of 14 discrete choice tasks.  Patients chose between 3 different GERD treatments described by 6 attributes: GERD medication cost, when medication was taken, diet changes, daytime discomfort due to GERD, sleeping discomfort due to GERD and side effects.  Additional data were gathered on health status, health-related quality of life, and sociodemographic characteristics RESULTS: 361 of 379 subjects completed the DCE.  Mean age was 57 years (S.D. 16); 48% were male; 41% paid some portion of prescription drug costs; a majority rated their GERD symptoms as mild to moderate.  Avoiding side effects was the most important attribute, followed by sleeping discomfort, daytime discomfort, dietary changes and medication cost.  Treatment choice was least affected by when the medications were to be taken. Patients were willing to pay (WTP) $16 for mild rather than moderate side effects and $14 for complete relief of nighttime symptoms rather than 1-3 episodes per month. Patients with less severe GERD symptoms were WTP more to avoid side effects. Older patients were less WTP for better relief than younger patients. Avoiding sleeping discomfort was more important to women. CONCLUSIONS: Patients are WTP more for a GERD medication that avoids side effects, nighttime and daytime discomfort and dietary changes.  Differences in preferences were found by gender and age. This information can help to guide physicians and patients in choosing GERD treatments