This chapter gives an overview on how the analytic hierarchy process (AHP) methodology can be used to elicit patients’ preferences and presents case studies on how this methodology may inform HTA and HTA-based decisions. Patients’ preferences are, together with external scientific knowledge and physician’s experience, the tenets of evidence-based medicine (Sackett et al., BMJ 312:71, 1996). To ensure that data on patients’ preferences is considered as robust evidence for decision-making, it should be generated in a methodologically sound, structured, and transparent way. AHP is a multiple-criteria decision-analytic (MCDA) method that can be used to elicit patients’ preferences for specific treatment characteristics or outcomes assessed in HTA. The steps in conducting an AHP are depicted. AHP follows transparent mathematical rules for data analysis but has its own methodological challenges and opportunities as depicted in this chapter. Examples of how AHP may be used in HTA and decision-making are provided and discussed.