OBJECTIVES There is evidence that in Greece, economic crisis has substantially affected chronic patients’ access to health care services. The aim of the study was to depict the current situation and identify the challenges and opportunities regarding the management of chronic diseases, in times of economic crisis and austerity from the aspect of both providers and patients.  METHODS Representatives of chronic patients and medical associations were invited to participate in a focus group session. Four diseases (Type 2 Diabetes, Hypertension, COPD, and Alzheimer) were selected based on their epidemiology and socioeconomic impact on the Greek healthcare system. Fifteen representatives participated and their statements were recorded, analyzed and categorized into 4 categories.   RESULTS Common issues in the management of chronic diseases under study appear to be the low quality of health services, fragmented primary care system and absence of specialized centers for the management of chronic diseases. These problems of the Greek health system were found to be magnified because of the recession. Furthermore, the increased numbers of unemployed, uninsured and patients at risk of poverty, puts additional pressure to the health system and futher undermines the quality of the health services. Economic and geographic barriers in access were reported, strengthening of the primary health system, development of patient registries, patient education regarding self-management and involvement of their associations in decision making was considered critical to the improvement of disease management. CONCLUSIONS The management of chronic diseases was challenging even before the economic crisis in Greece, but the current economic framework poses additional threats for the health care system jeopardizing patients’ health and its sustainability due to an increased risk for future costs. Investment in patients and physicians education regarding chronic diseases management was thought to be the key for improving this situation.