['Alexithymia is thought to be associated with the development of medically unexplained physical symptoms (UPS). So far little research has been published on alexithymia as a risk factor for the persistence of UPS.', 'To determine the clinical outcome in UPS patients and to study the relative importance of alexithymia in predicting that outcome.', 'A follow-up study was conducted among general medical outpatients with UPS. Patients underwent extensive examinations at baseline and were reassessed after a mean 61-week interval. Outcome of the UPS and general health perception at follow-up were used as major outcome variables.', 'Outcome of the UPS and general health perception at follow-up were not strongly associated with each other. More than half (63%) of the patients reported improvement of their initial symptoms, but only 38% of the patients considered themselves at follow-up to be in good health. UPS outcome was predominantly predicted by the duration of the UPS and the number of additional physical symptoms at baseline. General health perception at follow-up was predominantly predicted by the general health perception at baseline and the number of additional physical symptoms and pain experience at baseline. The explained variance of the general health perception was three times as high as the explained variance for the UPS outcome. Alexithymia was not associated with any of the two outcome variables.'] Does alexithymia predict the persistence of medically unexplained physical symptoms?