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Background Coeliac disease is an autoimmune disorder that is considered to affect approximately one in 100 people. In the UK, gluten-free (GF) foods can be prescribed by general practitioners ( GPs) to treat this condition and there are national guidelines on the quantities of GF food an individual should receive on prescription. Information on actual prescribing behaviour by GPs, and how this compares with guideline recommendations, is scarce. The present study aimed to describe GPs prescribing practice of GF foods, within one locality in the UK, comparing this with national guidelines. Methods A retrospective evaluation of GP electronic medical records for all patients with a gluten-sensitive enteropathy diagnosis and/or those prescribed GF food between April 2010 and March 2011 was carried out in 16 GP practices in the west of Scotland, serving a total of 85 667 patients. Results Of 175 (0.18% of the total practice population) patients, 152 were identified with coeliac disease, eight with dermatitis herpetiformis and six with both conditions. A further nine patients received GF foods on prescriptions with no recorded diagnosis. There was a positive association between adherence to the prescribing guidelines and female sex ( P < 0.0001) and (for those with a recorded diagnosis) increasing age ( P = 0.001). There was no significant association between either socio-economic deprivation or co-morbidities and adherence to the prescribing guidelines. Conclusions There was significant under prescribing of GF foods in those identified. Further research is required to establish whether these results are representative of wider practice in the UK. [ABSTRACT FROM AUTHOR]