OBJECTIVES: To assess doctors' perceptions of their patients' satisfaction and expectations in primary care. STUDY DESIGN: Cross-sectional study using questionnaires completed by general practitioners (GPs) and their patients. SETTING: Primary care practices in Geneva, Switzerland. PARTICIPANTS: 23 GPs from a random list of 75 GPs practising in the canton of Geneva (participation rate 31%), who each recruited between 50 and 100 consecutive patients coming to the practice for a scheduled medical consultation, leading to a total of 1637 patients (participation rate: 97%, women: 63%, mean age: 54 years). Patient exclusion criteria were: new patients, those consulting in an emergency situation or suffering from disorders affecting their ability to consent, and those who did not speak French. MAIN OUTCOME MEASURES: Patients satisfaction with and expectations from the care they received in this practice; GPs perceptions of their patient's satisfaction and expectations. RESULTS: GPs underestimated all patient satisfaction items (p<0.001 for all items) whereas they overestimated their expectations, except for equipment (laboratory and X-ray) and some accessibility items. In a multivariate analysis to assess which GP factors were associated with correct assessment of their patients' views, only GPs' certification status was a significant factor. CONCLUSIONS: GPs tend to underestimate patients' satisfaction but overestimate their expectations in primary care. These findings may help GPs to understand patients' views in order to adequately meet their expectations and concerns.