OBJECTIVES: To evaluate use of resources and health-related quality of life (HRQOL) in Spanish subjects with IBS compatible symptoms meeting and not meeting the Rome II criteria. METHODS: Cross-sectional study in a representative sample of 222 subjects with IBS compatible symptoms. Data were obtained in face-to-face interviews performed in the respondent’s home. Data on IBS compatible symptoms, number of medical visits, diagnostic tests, drugs, disability days, and restrictions on main activity during the previous 12 months were compared between subjects meeting the Rome II criteria and those who did not. HRQoL was measured using the SF-36. RESULTS: Compared to subjects with IBS compatible symptoms who did not meet the Rome II criteria, a greater proportion of subjects meeting the Rome II criteria had consulted a health care professional (67.7 vs 41.4%), principally GPs (49.2% vs 31.8%) and gastroenterologists (27.7 vs 8.9%), had been performed a diagnostic test (35.4% vs 17.2%), were taking medication (70.8% vs 45.2%), were unable to perform their main activity (21.5% vs 10.8), or reported restrictions on their main activity (60% vs 27.4%). Subjects meeting IBS Rome II criteria reported worse HRQOL than members of the general population on all dimensions of the SF-36 (p<0.05) except Physical functioning and Role functioning. CONCLUSIONS: IBS subjects meeting the Rome II criteria reported greater use of health resources than subjects with IBS compatible symptoms who did not meet the Rome II criteria, and they reported worse HRQoL when compared with the general population.