BACKGROUND AND OBJECTIVES: Empathy is considered a prerequisite for a successful physician-patient relationship. The Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) is a regularly-used, patient-rated measure of physician empathy. The aim of this study is to translate and analyze the reliability and validity of the JSPPPE Spanish (Spain) version (Sp-JSPPPE) in primary care in order to use it with medical trainees. METHODS: After translation and back translation of the JSPPPE, 369 patients from 21 primary care physicians in Pamplona (Navarre, Spain) completed the Sp-JSPPPE, a sociodemographic questionnaire, the Spanish (Spain) Consultation and Relational Empathy Measure (Sp-CARE), and a question about overall satisfaction. We studied internal reliability (Cronbach's alpha and ordinal alpha), homogeneity (corrected item-total correlations), construct validity (confirmatory factor analysis [CFA]) and concurrent validity (Spearman's correlation) of Sp-JSPPPE. RESULTS: Cronbach's alpha and ordinal alpha were 0.870 and 0.919, respectively, for the Sp-JSPPPE, and all corrected item-total correlations exceeded the accepted cutoff of 0.30, demonstrating high internal reliability and homogeneity. CFA corroborated the one-factor structure proposed in the original version. The total score for the Sp-JSPPPE was significantly correlated with sp-CARE (Spearman's rho 0.651, P <.001) and with overall patient satisfaction (Spearman's rho 0.504, P <.001). CONCLUSIONS: The results support the reliability and validity of the Sp-JSPPPE in primary care. Sp-JSPPPE could be useful in empathy assessment of medical trainees, both graduate and postgraduate, in the Spanish context.