ObjectiveThe only available treatment for coeliac disease (CD) is a lifelong strict gluten-free diet (GFD), which can be extremely challenging. Τhe aim of the present study was to gain an insight into patients' perceptions regarding the GFD, in relation to difficulties experienced, disease-specific symptoms, adherence level, and information sources used.MethodsTwo hundred ninety CD patients (247 women and 43 men) aged 18–74 years, completed a self-administered questionnaire.ResultsSelf-rated dietary adherence was high in 65.5%, moderate in 27.5% and poor in 6.9% of the patients.The main difficulties encountered were the high cost and limited availability of GF foods and meals in markets and restaurants. The main source of information concerning CD and GFD was the internet, and the most useful source was the Coeliac Society. Dietary adherence correlated positively with Coeliac Society membership and awareness of the monthly CD allowance.ConclusionΑ substantial proportion of patients did not adhere to a strict GFD. Patients were not adequately followed-up.InnovationA self-administered questionnaire was used to explore the practical challenges of a GFD in an understudied population, Greek adult coeliac patients. The results highlighted the need for dietitians with expertise on CD.