OBJECTIVES: The time trade-off (TTO) and the standard gamble (SG) are two methods for the direct measurement of health-related quality of life (HRQoL) in a population. These tools may be used not only in patients but also to evaluate the general public’s preference for a particular health state. The purpose of this study was to undertake a systematic review of the literature comparing TTO and SG outcomes for the general population. METHODS: Ovid Medline® was scoured to gather original studies published in English since 1996 reporting both mean TTO and SG outcomes from members of the general public who were asked to evaluate hypothetical health states.  Two researchers, with a third acting as adjudicator, independently undertook the review of the literature, the inclusion/exclusion process and data extraction. Statistical analyses were performed on study arms (studies) for differences and/or correlation between utility scores derived from TTO and SG.   RESULTS: Of the 170 publications yielded by the initial literature search, 19 pertinent articles were included in the present analysis, covering 24 disease categories, 77 studies and 17,515 subjects.  The overall weighted mean health utility scores were 0.82 with TTO and 0.83 with SG.  Studies reporting a greater than 10% absolute difference between the two measurement tools represented 13% (k=10), while 22% reported greater than 10% relative difference (k=17), 51% reported overall higher utility scores with SG (k=39) and 13% reported equal scores (k=10). The most common disease category, discussed in 8 studies covering 2,490 participants, was ocular disease.   Spearman’s rank test yielded significant positive correlation (r = 0.924).      CONCLUSIONS: The majority of studies displayed little difference in scores between the TTO and SG methods collected from the general public. A high positive correlation was observed between utility scores reported by the two methods.