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Patient satisfaction measures have previously addressed satisfaction with medical care, satisfaction with providers, and satisfaction with outcomes, but not satisfaction with the health care decision itself. As patients become more involved in health care decisions, it is important to understand specific dynamics of the decision itself. The Satisfaction with Decision (SWD) scale measures satisfaction with health care decisions. It was developed in the context of postmenopausal hormone-replacement therapy decisions. The six-item scale has excellent reliability (Cronbach's alpha = 0.86). Discriminant validity, tested by performing principal-components analysis of items pooled from the SWD scale and two conceptually related measures, was good. Correlation of the SWD scale with measures of satisfaction with other aspects of the decision-making process showed the SWD scale was correlated most highly (0.64) with "decisional confidence," and least with "desire to participate in health care decisions" and "satisfaction with provider." The SWD scale predicts decision certainty in this study. Use in an independent study showed that the SWD scale was correlated with the likelihood of patients' intentions to get a flu shot. Further investigation in relation to other health decisions will establish the utility of the SWD scale as an outcome measure.