Abstract-In this paper, the trade-off between energy efficiency (EE) and spectral efficiency (SE) is analyzed for both the uplink and downlink of the distributed multiple-input multiple-output (DMIMO) system over the Rayleigh fading channel while considering different types of power consumption models (PCMs). A novel tight closed-form approximation of the DMIMO EE-SE trade-off is presented and a detailed analysis is provided for the scenario with practical antenna configurations. Furthermore, generic and accurate low and high-SE approximations of this trade-off are derived for any number of radio access units (RAUs) in both the uplink and downlink channels. Our expressions have been utilized for assessing both the EE gain of DMIMO over co-located MIMO (CMIMO) and the incremental EE gain of DMIMO in the downlink channel. Our results reveal that DMIMO is more energy efficient than CMIMO for cell edge users in both the idealistic and realistic PCMs; whereas in terms of the incremental EE gain, connecting the user terminal to only one RAU is the most energy efficient approach when a realistic PCM is considered.