To analyze factors that influence the degree of patient satisfaction, we examined satisfaction with treatment of birch pollinosis using a questionnaire. Eighty-three birch pollinosis patients who consulted hospitals in Hokkaido between April and June 2004, were assessed for patient satisfaction employing symptom scores, examination of the nasal cavity and QOL questionnaires. Patient satisfaction with treatment was evaluated using a visual analog scale (VAS). The average VAS value was 7.4. Twenty patients scored 10 (satisfied) and one patient scored 0 (unsatisfied). There was no significant association of patient satisfaction with gender, age, drowsiness due to medication, forgetting to take medicine or price of medicine. Regarding clinical symptoms, nasal obstruction was identified as the most important symptom influencing patient satisfaction. However, none of the findings on observation of nasal cavity correlated with patient satisfaction, although the QOL score indicated that “limitation of outdoor activity” was an important factor influencing patient satisfaction. These findings suggested that in order to raise patient satisfaction, treatment of birch pollinosis should target nasal obstruction.