Patients with neuropathic pain (NeuP) report poorer health-related quality of life (HRQoL) and incur higher healthcare costs than non neuropathic pain patients. Although the impact of NeuP on HRQoL has been the subject of previous reviews, the health utility associated with NeuP remains unclear. Knowledge regarding this association is needed, as it impacts economic evaluations of treatments for NeuP. OBJECTIVES: To undertake a systematic review and meta-analysis of published health utility values of patients with NeuP. METHODS: A detailed search of bibliographic medical databases (Medline, Embase, Cochrane Library) and specialist economic databases (NHS Centre for Reviews and Dissemination Economic Evaluation Database and Health Economics Evaluation Database) was undertaken (to September 2008). Reference lists of retrieved reports were also searched. Studies reporting utility single-index measures (preference based) in NeuP were included. Random effects meta-analysis was used to pool utility estimate across studies. The association of utilities and a number of pre-defined factors (NeuP indication, patient age, sex, duration and severity of pain and method of utility scoring) was examined using meta-regression. RESULTS: Twenty three studies reporting utility values in patients with NeuP were included, of which 11 were randomised trials that also reported the treatment change in utility. The weighted pooled mean utility score across the studies was 0.48 (95% CI: 0.44 to 0.53). There was evidence of substantial statistical heterogeneity across studies (P<0.0001). Although we found little evidence of variation in utility across patient characteristics or NeuP indication, increasing pain severity was found to be strongly associated with a reduction in utility. CONCLUSIONS: This study confirms that NeuP patients experience low utilities and therefore poor quality of life. Pain severity appears to be a major driver of the negative health impact of NeuP and therefore needs to be considered in future economic evaluations of interventions for this patient population.