OBJECTIVES: Gastroesophageal Reflux Disease is a chronic condition whose symptoms cause great impairment on a patient’s quality of life. Our aim was to evaluate GERD patients Health Related Quality of Life (HRQoL) and its association to clinical status. METHODS: A cross-sectional observational multicentre cost of illness study was conducted in the urban area of Milan. The study involved 317 patients (mean age 59 years, 58% female) sequentially enrolled by 47 General Practitioners. Information was collected investigating demographic, clinical, economic and quality of life variables. To assess QoL in GERD patients we used a generic (EuroQol) and a specific (Quality of Life in Reflux and Dyspepsia, QOLRAD heartburn version) questionnaire. We report on QoL data. RESULTS: A strong impairment in the HRQoL was documented both with EQ-5D and QOLRAD instruments. Patients reported an average value of 64.4 in the EQ-VAS, significantly lower compared to general population. The EQ-profile indicated that ‘pain/discomfort’ and ‘anxiety/depression’ were the most impaired domains. We converted the EQ-profile in economic utility score by means of values from UK and Catalonia. Using the UK conversion values we had a utility mean score of 0.70 (±0.23), using the Catalonia conversion values the mean score was 0.79 (±0.21). The EQ-VAS value significantly decreased with age, heartburn, epigastric pain, odynophagia, globus sensation, relapse of symptoms and with all the QOLRAD domains. The most impaired QOLRAD domain was ‘food/drink problems’, the less one was ‘physical/social functioning’ with a mean value of 4.95 and 5.74 respectively (one worst, seven best imaginable health state). The internal consistency tested with Cronbach’s alpha was > 0.8 for all domains. Results with QOLRAD were confirmed by those with EQ-5D. CONCLUSIONS: This is the first Italian study on quality of life of GERD patients visited by GP's, highlighting that this disease significantly impairs global patients’ HRQoL.