OBJECTIVES: Neuropathic pain (NP) is a chronic progressive disease which is hard to control. This analysis investigates patients’ satisfaction with pain therapy and its relationship with pain severity and health related quality of life (HRQoL). METHODS: Data were drawn from the 2012 Adelphi NP Disease Specific Programme, a cross-sectional study involving 413 primary care physicians and specialists across Europe. Physicians provided detailed records for 3956 NP patients, of which 1568 patients voluntarily completed EQ-5D and Brief Pain Inventory questionnaires. HRQoL was measured via the EQ-5D, satisfaction via a three-option question answered by the patient, and pain via the Brief Pain Inventory (BPI) interference score. Boxplot analyses were used to compare outcomes across satisfaction groups. RESULTS: Only 64 (4.08%) were satisfied with their treatment, and 1504 (95.92%) not satisfied. A positive relationship was observed between satisfaction and HRQoL, with the most satisfied group recording a 31.62% higher EQ-5D score (mean 0.75 versus 0.57, p<0.01) relative to the next most-satisfied group. A negative relationship was observed between satisfaction and pain, with the most satisfied patient group scoring 30.89% lower pain scores (mean 3.40 versus 4.91, p<0.01). CONCLUSIONS: Most neuropathic pain patients are not satisfied with their current pain therapy. This analysis suggests a negative relationship between treatment satisfaction and reported pain severity as well as a clear positive relationship between treatment satisfaction and health related quality of life. The results highlight the need for a more targeted treatment of neuropathic pain patients.