Purpose Perceived discrimination in medical setting is associated to adverse healthcare outcomes. Yet, few tools exist for assessing such discrimination among patients in Portugal. This study aimed to validate the Discrimination in Medical Settings (DMS) scale for the Portuguese Roma population, explore their experiences of healthcare discrimination and analyze the association between perceived discrimination, health perception and healthcare trust. Design/methodology/approach In this cross-sectional study, 84 Roma adults (60,7% women) completed the DMS, along with microaggression assessments, health perception and healthcare trust evaluations. Findings The seven-item DMS scale yielded a one-factor structure that explained 71.80% of variance, with strong reliability (a = 0.89). The average DMS-measured perceived discrimination was 2.46. Discrimination correlated inversely with health perception and was strongly negatively associated to trust in healthcare. Originality/value The DMS scale exhibited reliability, single-dimensionality and validity among the Roma. High perceived discrimination in medical settings among Portuguese Roma was notably associated with individual health perception and healthcare trust.