OBJECTIVES: The aim of the current study is to examine how unmet needs, defined as prevalence rates, treatment rates, and quality of life, compare between Spain and other countries in the EU.  METHODS: Data from the EU National Health and Wellness Survey (NHWS) were used (N=57,805), with respondents from France, Germany, Italy, Spain, and UK (“5EU”). NHWS is an internet-based survey which relies on a random stratified sampling framework to ensure demographic representativeness of each country. Among the 10 most prevalent conditions in 5EU, differences in prevalence, treatment rates, and health utilities (using the SF-6D) were compared between 5EU and Spain (N=5,039).  RESULTS: Prevalence rates were lower in Spain for 7 of the 10 conditions investigated. Despite the lower prevalence rates, treatment rates for these conditions were consistently higher. The single exception was dyslipidemia, which was more prevalent in Spain (24.2% vs. 14.7%) and had a lower treatment rate (50.7% vs. 56.0%) than elsewhere in 5EU.  Stronger beliefs in seeing their physician and in prescription medications were also reported by Spanish patients relative to elsewhere in 5EU. The greatest unmet needs in Spain, defined as high prevalence estimates and low treatment rates and health utilities, were reported for patients with insomnia/sleep difficulties (Prevalence=27.6%, Treatment rate=31.4%, Utilities=0.67) and anxiety (Prevalence=23.3%, Treatment rate=41.2%, Utilities=0.62). CONCLUSIONS: The results suggest prevalence rates are generally lower in Spain than the rest of 5EU though treatment rates are higher.  The latter finding could be due to a greater belief in regular contact with physicians and prescription medications in general. Nevertheless, several unmet needs exist for Spanish patients, particularly for insomnia/sleep difficulties and anxiety.