OBJECTIVES: To summarize published data on the burden of GAD to assist decision makers in Germany. METHODS: A review of English-language studies on the human, healthcare and economic burden of GAD in Germany. Studies were identified using electronic databases (MEDLINE/EMBASE) and references from published articles. RESULTS: National prevalence estimates indicate that GAD affected 1.5% of adults in the general population in the past 12-months and 5.3% of primary care patients in the past 1-month. GAD commonly co-occurred with other mental disorders, especially major depression (MD). Impairments observed in people with GAD were not merely due to comorbidity. People with pure GAD (GAD without comorbid MD) reported high levels of occupational impairment that were similar or greater in magnitude compared to that of people with pure MD (MD without comorbid GAD). People with pure GAD also reported more severe mental and physical health status impairments compared to people with pure MD. High use of health care resources among GAD primary care patients was not solely due to comorbidity. The proportion of comorbid GAD/MD cases was smaller than that of pure GAD cases (4-week point prevalence estimates of 1.6% and 3.8%, respectively). A greater proportion of primary care patients with comorbid GAD/MD (43%) and pure GAD (42%) reported high use of specialists (2+ visits/year) than pure MD patients (36%). A greater proportion of GAD patients sought help for somatic illness/complaints (48%), pain (35%) and sleep problems (33%) than for anxiety (13%). GAD was considerably less likely to be recognized and treated than MD. The per-patient cost of GAD (€1628 in 2004) was higher than that of any other anxiety disorder, owing to lost work and healthcare utilization. CONCLUSION: German data show that GAD is a distinct and burdensome disorder. Improved recognition and treatment of GAD should be an important public health priority.