Introduction: Patient satisfaction is an intuitively important outcome measure and has been previously linked to general health status. Previous research on patient satisfaction after injury has concentrated on satisfaction with medical care. This study aims to explore possible predictors of patient satisfaction with outcome following major trauma. Methods: A cross-sectional survey involving consecutive adult patients involved in major accidental trauma from a major metropolitan trauma centre, over a 5-year period, was performed between 1 and 6 years post-injury. The outcome used was patient satisfaction with progress since the injury. Multiple Logistic regression was used to develop a model of significant predictors of patient satisfaction. Results: The survey was mailed to 728 eligible patients, 56 were excluded due to death or inability to complete the survey, 93 refused to participate and 90 were not contactable. One hundred and thirty-four patients did not respond and 355 completed surveys were returned. Patient dissatisfaction was found to be significantly associated with unemployment at the time of follow up (OR, 2.38; 95% CI, 1.38-4.08; p = 0.004), having one or more chronic illnesses at the time of injury (OR, 2.57; 95% CI, 1.45-4.55; p = 0.001), being involved in a motor vehicle accident (OR, 1.83; 95% CI, 1.02-3.30; p = 0.04) and having an unsettled compensation claim (OR, 5.19; 95% CI, 2.80-9.65; p < 0.0001). Patient satisfaction was not significantly associated with any measure of injury severity. Conclusions: Having an unsettled compensation claim after major trauma is the strongest predictor of patient dissatisfaction following major trauma, allowing for other factors. (C) 2007 Elsevier Ltd. All rights reserved.