OBJECTIVES: To compare clinicians’ and patients’ views of post-stroke spasticity (PSS) symptoms and their impact on health-related quality of life (HRQoL). METHODS: Interviews were conducted with 13 clinicians specializing in the treatment of PSS.  Emergent themes from these interviews were compared with the findings from 6 patient focus groups involving 59 patients. RESULTS: Clinicians described altered muscle tone and spasticity as distinct manifestations of upper motor neuron syndrome but suggested that patients do not distinguish between the two. Clinicians perceived patients to view spasticity as muscle tightness/stiffness that affects limb positioning, posture, and function, with patient values and coping strategies influencing the degree to which PSS impacts various domains of their lives. Existing HRQoL measures were thought to be too general and to overlook specific consequences associated with PSS. Patients described PSS in terms of movement difficulties, and not muscle characteristics.  Specifically, patients characterized PSS as an inability to direct arm movements, position the hand, and grasp objects in the upper limbs; and, as an inability to walk, maintain balance, and minimize the risk of falls in the lower limbs.  Ten HRQoL domains were found to fully represent the effects of PSS on individual well being: symptom impact, physical function, activities of daily living, ambulation and mobility, ambulation risk, social function, social support, loss of role function, appearance, and adaptive resiliency. CONCLUSIONS: While clinicians and patients generally agreed on the functional areas affected by PSS, clinicians tended to focus on diagnostic features of excess muscle tonicity and spasm whereas patients concentrated on the complex psychosocial effects of PSS - particularly the effects of disability on their sense of self and personal relationships. An understanding and assessment of the complex ways that PSS impacts patients’ lives has clinical relevance, particularly in terms of screening for disabling PSS and treatment decisions.