The common perspective of physicians on chronic urticaria (CU) refers to a benign disorder with no pain and no threat to function or life. Heath-related quality-of-life (HRQOL) tools have demonstrated the extent to which physicians underestimate the impact of this disorder. From the patient perspective, CU affects as many dimensions of the HRQOL as some life-threatening diseases or well-recognized disabling chronic skin disorders, such as psoriasis or atopic dermatitis. Pruritus as well as swelling and wheals triggered by unavoidable events, such as pressure or sweating, greatly contribute to HRQOL impairment. Recent trials have suggested that dermatology-specific HRQOL instruments could be more relevant than more objective severity scores when studying and comparing the benefit of various therapeutic strategies in chronic idiopathic urticaria.