OBJECTIVES: To characterize the use of health care services and the corresponding costs of patients with Neurological Disorders (ND) managed at Primary Care Settings (PCS) under usual medical practice. METHODS: A retrospective, multicenter study was carried out. All patients seen by 5 PCS during year 2006 with at least one demand for ND care (CIAP-2: component-7) were included in the analysis. The control group was formed with the rest of patients without NDs. Outcomes measures included sociodemographics, comorbidities, Charlson index (severity), use of health care resources and ambulatory costs (drugs, diagnostic / therapeutic procedures, referrals and visits). Statistical analysis included descriptive, logistic regression model and ANCOVA models. RESULTS: A total of 80,775 patients were included, of which 19,423 had any ND (24.0%; 95%CI: 23.7 24.3%). Patients requiring health care for their ND were older (46.2±22.1 vs. 38.9±22.9, p<0.001), with increased severity (0.3±0.6 vs. 0.2±0.5, p<0.001), predominantly female (63.6 vs. 49.8%, p<0.001), larger number of health problems (6.1±4.0 vs. 4.3±3.2, p<0.001) and increased per patient per year medical visits (9.9±9.4 vs. 7.2±7.7, p<0.001) and days of work absenteeism due to disability (73.3±124.4 vs. 56.8±107.6, p<0.001). Main symptoms demanding care were: vertigo/dizziness (25.6%) and headache (17.7%). Neurological treatment was associated with women (OR=1.8), depressive syndrome (OR=1.5) and cardiovascular events (OR=1.2), p<0.0001 in all cases. Crude and adjusted (age, gender and comorbidities) mean annual cost were significantly higher in patients with NDs than in controls; €708.25±900.94 vs. €443.10±678.44, p<0.001, and €932.87 vs. €712.38, p<0.001. All per patient per year components of costs (fixed/semi-fixed, tests, referrals) were significantly higher in the ND group, particularly pharmaceutical expenditure; €621.26 vs. €479.25), p<0.001. CONCLUSION: Patients requiring care for NDs in the primary care setting showed a large number of comorbidities, increased use of health resources and higher per patient per year cost.