OBJECTIVES: To evaluate whether painDETECT, a screening questionnaire to identify neuropathic pain (NeP), can differentiate pain severity in patients with NeP. METHODS: Subjects (N=624; 55.4% male, 71.8% white, mean±SD age 55.5±13.7 years) with confirmed diagnoses of NeP were identified during routine office visits to U.S. community-based physicians. The Brief Pain Inventory was used to stratify subjects by mild (score 0-3; n=110), moderate (score 4-6; n=297), and severe (score 7-10; n=207) pain. Scores on the 9-item painDETECT (seven pain symptom items, one pain course pattern item, and one pain irradiation item) range from -1 to 38; the 7-item painDETECT scores (only pain symptoms) range from 0 to 35. The ability of painDETECT to discriminate pain severity was evaluated using analysis of variance or covariance models (with Tukey’s adjustment for pairwise comparisons) to obtain unadjusted and adjusted (age, gender, race, ethnicity, time since NeP diagnosis, and number of comorbidities) mean painDETECT scores. Cumulative distribution functions on painDETECT scores by pain severity were compared (Kolmogorov-Smirov test). Cronbach’s alpha assessed internal consistency reliability. RESULTS: Unadjusted mean scores were 14.3 for mild, 18.6 for moderate, and 22.7 for severe pain for the 7-items, and 15.2, 19.8, and 24.0, respectively, for the 9-items. Adjusted 7-item mean scores for mild, moderate and severe pain were 16.4, 20.1 and 24.0, respectively, and adjusted 9-item mean scores were 17.3, 21.3 and 25.3, respectively. All pairwise comparisons of mean scores between pain severity groups were statistically significant (P<0.0001). Cumulative distribution functions showed distinct separation between pain severity groups (P<0.0001). Cronbach’s alphas were 0.80 and 0.76, for the 7- and 9-item scales, respectively. CONCLUSIONS: This study is the first to provide strong psychometric evidence on the validity and reliability of painDETECT for distinguishing severity of NeP, further supporting its clinical relevance for identifying and characterizing NeP.