GPs often wrongly assume patients' expectations and overestimate their knowledge about paracetamol. Both GPs and patients perceive paracetamol as a weak painkiller for acute sore throat; for patients this can be attributed to the incorrect use. Patients' primary source of information about medication is their GP, whom they deeply trust ABSTRACT Background: Paracetamol is recommended as first-line treatment for an acute sore throat. However, in primary care, antibiotics are still frequently prescribed as first-line management for sore throat. Objectives: We aimed to explore the views and experiences of general practitioners (GPs) and patients regarding paracetamol for sore throat to understand why guidelines are often not adhered to. Methods: A descriptive qualitative study with semi-structured interviews was conducted with a purposive sample of eight GPs and nine patients in Antwerp (Belgium). Data was analysed using thematic content analysis. Results: The mean age of GPs was 42.4 years and of patients 51.4 years. Patients want reassurance and pain relief. Many patients do not self-manage their acute sore throat with paracetamol before consulting their GP. GPs often wrongly assume that the patient has already used pain relief without actually exploring this. Patients who do use paracetamol, do not know how to use it effectively. This leads to the perception and beliefs that it is insufficient to treat acute sore throat and when prescribed will lead to dissatisfaction. Patients generally accept the GP's recommended treatment when given a thorough explanation, since they trust their GP's expertise. Conclusion: GPs play a major role in educating patients about paracetamol as effective painrelieving treatment in acute sore throat. By actively exploring the patients' ideas, concerns and expectations (ICE), patients' satisfaction and guideline adherence could be improved.