Abstract-Distributed multiple-input multiple-output (D-MIMO) is a promising technique for next generation wireless networks, which offers a remarkable spectral efficiency gain over the conventional co-located MIMO (C-MIMO). In contrast to C-MIMO, which can be regarded as a special case of D-MIMO, performance analysis of D-MIMO is a challenging problem. This is because radio channels between a user and the distributed radio ports (RPs) are characterized by non-identical path-loss and shadowing effects which render the classical analytical methods non-tractable. In this paper, new accurate expressions for the uplink spectral efficiency of D-MIMO and C-MIMO systems are presented and compared for given large-scale coefficients. We further consider the uplink spectral efficiency for a single-cell distributed large-scale MIMO (D-LMIMO) system with linear zero-forcing (ZF) receivers, accounting for path loss along with shadow fading and multi-path fading effects. Exact expressions for the average spectral efficiency over shadow fading in the asymptotically very large number of RPs antennas regime is explicitly derived, and a tight closed-form lower bound on the asymptotic spectral efficiency is presented. We demonstrate that, the transmit power of each user in D-LMIMO can be scaled down proportionally to the inverse of the number of RP antennas with no performance reduction. Moreover, we study the spectral efficiency of a D-MIMO in a multi-cell environment taking into account accurate co-channel interference (CCI) models. These expressions provide meaningful insights into the impact of SNR, RPs and user positions, number of RPs antennas, shadow fading, and out-of-cell interference on the spectral efficiency of D-MIMO over practical scenarios. Finally, numerical results are validated by simulation to confirm our analysis.Index Terms-Distributed antenna system (DAS), multipleinput multiple-output (MIMO) systems, large-scale MIMO (L-MIMO), spectral efficiency, zero-forcing (ZF) receiver, co-channel interference (CCI).