Background Numerous studies have shown that hypnotherapy (HT) improves the symptoms of irritable bowel syndrome (IBS) using clinical outcome measures. In light of the increasing interest in capturing the patient’s perception of their illness and treatment, it was felt it would be helpful to record how patients perceive the hypnotherapeutic process, on which there is currently little information. Aims In addition to measuring symptom change, we have recently started to record the patient’s perception of hypnotherapy for their IBS, including their expectations, and now report the results for the first 50 patients. Methods 50 consecutive IBS patients (38 females and 12 males, age range 18-76) attending for hypnotherapy were asked to complete questionnaires recording their IBS symptom severity (IBS SSS), quality of life, non-colonic symptoms, anxiety and depression before and after treatment. In addition, they completed questionnaires detailing their perception of HT, other people’s perception of HT and their expectations about the efficacy of HT. Their perceptions about the hypno-therapeutic process were assessed both quantitatively and also qualitatively using patient descriptions. Furthermore, the analysis compared the characteristics of responders and non-responders. Results 39 out of 50 patients (78%, p<0.001) responded to treatment (50 point or more reduction in IBS SSS), which is exactly consistent with our previously published data. Pain scores, non-colonic symptoms, quality of life, anxiety and depression also significantly improved after HT (all p<0.001). When asked how patients felt before treatment, 52% of responses portrayed hypnotherapy negatively compared to 3% after treatment. The relatives and doctors of patients were generally supportive of HT although one cognitive behavioural therapist advised against it. In responders, 19 patients (48.7%) expected hypnotherapy to be effective prior to starting it, whereas in non-responders, 7 (64%) expected treatment to be successful. Interestingly, 9 of 11 non-responders (82%) considered treatment worthwhile despite no significant effect on their symptoms. This may be because 46 patients (92% of all patients) had found HT helped them with other issues, such as dealing with stressful situations or poor sleep. Conclusion Although initially being perceived negatively, hypnotherapy significantly improved symptoms and resulted in other benefits not related to the gastrointestinal system. Inter-estingly, those with greater expectation about treatment did not seem to do quite so well, suggesting that high expectations are not necessary for a good outcome.