OBJECTIVES: The purpose of this study was to assign utilities to the three different severity grades of hand-foot-syndrome (HFS) which is a dose and therapy limiting toxicity in cancer patients undergoing treatment with e.g. capecitabine, docetaxel, sunitinib and sorafenib. HFS can develop from mild skin reactions at hands and feet (grade 1) to major skin reactions with bleeding, ulceration and severe pain (grade 3). METHODS: In a survey conducted in a German community pharmacy, randomly chosen subjects were introduced to the symptoms of HFS using cards explaining the different HFS grades by pictures of hands and feet, a clinical definition and citations of patients. Participants were asked to imagine suffering from each HFS grade for the next 10 years followed by death. Then they valuated the different grades using the time-trade-off-method (TTO) and the visual analogue scale (VAS). RESULTS: Fifty-three participants (30 female = 56.6%, 23 male = 43.4%) valuated the different HFS grades. Their mean age was 50.8 years (median: 49.0, SD: 18.5, range: 18 – 86 years). The following mean utilities were assessed using the TTO: grade 1 = 0.97 (median: 1.00, SD: 0.08), grade 2 = 0.72 (median: 0.80, SD: 0.23) and grade 3 = 0.34 (median: 0.30, SD: 0.22). The VAS resulted in the following mean utilities: grade 1 = 0.70 (median: 0.70, SD 0.14), grade 2 = 0.37 (median: 0.40, SD: 0.13) and grade 3 = 0.09 (median: 0.10, SD: 0.08). All differences among the severity grades were statistically significant (p <0.001). CONCLUSION: The adults questioned see a significant impact of the adverse drug reaction HFS on the health status of patients. Therefore HFS deserves awareness and respect by health care professionals and requires a high level of patient information. Furthermore scientists should be encouraged to conduct more studies concerning prevention and management of HFS.