OBJECTIVES: The EQ-5D has been translated into many languages. The Euroqol group have recently altered and clarified the VAS scale. The objective of this study was to produce translations that are conceptually equivalent to the original and to other language versions, ensuring the relevance of the translations within the target cultures. METHODS: A standard methodology was employed: 1 forward and 1 back translation, review and developer review; or an in-country review and developer review; linguistic validation interviews with 8 subjects, a mix of healthy people and patients, a second developer review and 2 proofreadings. RESULTS: The translation process highlighted numerous cultural and linguistic issues, including: 1) Cognitive interviews showed that there was no clear Dutch word for scale, so an explanation likening the scale to a thermometer as in the previous 3L VAS was necessary; 2) In some cultures ‘mark an X on the scale’ was difficult to render, and had to be amended by using alternative verb formations and formatting; 3) Though the new VAS mentions only ‘health’, in some languages, it was necessary to use “health state” to avoid confusion, e.g. in Czech “health” alone means “good health.”; 4) In some languages the concepts of “health” and “health state” had different temporal associations. In Korean, “health” referred to a longer period of time, so “health today” had to be expressed by “health state today”; 5) Russian patients understood “health state” as the evaluation given by a doctor or test results, therefore “in your opinion” was added.CONCLUSIONS: The EQ-5D VAS has been translated and linguistically validated using a rigorous translation process. A number of cultural and linguistic issues became apparent and were resolved. The measure is now appropriate for use in multinational trials.