BACKGROUND: Osteoarthritis (OA) has a high prevalence in primary care. Patient satisfaction is an important indicator for the quality of care provided to OA patients. Little is known about satisfaction of patients with this condition in a primary care setting in Germany. The aim of the study was to assess current satisfaction of patients and reveal possible disease and quality of life related predictors. METHODS/DESIGN: Seventy-five German GPs approached 1250 patients with OA consecutively. Sociodemographics, OA-specific quality of life (GERMAN-AIMS2-SF), co-morbidities and depression (using PHQ-9) were assessed. Patient satisfaction was measured by means of the European Task Force on Patient Evaluations of General Practice (EUROPEP) instrument. A stepwise linear regression analysis with the EUROPEP score as dependent variable controlled for the amount of GP visits was performed to assess predictors of satisfaction. RESULTS: A total of 1021 OA patients returned the questionnaire. The adjusted R(2) of the final model was 0.270 (P < 0.001). The main predictors were the PHQ-9 score (beta = -0.372; P < 0.001), age (beta = -0.185; P < 0.001), living alone (beta = -0.209; P < 0.001) and number of co-morbidities (beta = -0.152; P < 0.001). The only disease-related factor which remained as predictor of patient satisfaction was duration of OA (beta = -0.105; P = 0.008). DISCUSSION: The finding that depression and social factors are more important for patient satisfaction with provided care than disease-related aspects suggests that these factors need to be considered carefully in treatment. This represents a big challenge within an increasingly specialized health care system. The General Practitioner as the regular and first-choice provider of health care seems to be the most appropriate instance who can accomplish this.