Background: Auditory verbal hallucinations are common symptoms in psychosis conditions and will be distressing and persistent for many people. Though we are developing an improved understanding of their presentation in service users, far less is known about their impact on informal carers. Objectives: This study examines whether the presence of auditory verbal hallucinations in service users uniquely influences carers’ appraisals of caregiving and the illness, and impact on their affective functioning, coping style and experience of stigma. Methods: The study used a cross-sectional design. Carers (n = 52) were recruited from dedicated carer services attached to psychosis community mental health teams. The sample included 26 carers of service users who hear voices, and 26 carers of service users who do not hear voices. Participants completed self-report measures on their experience of caregiving, illness beliefs, affective disturbance and avoidant coping. Results: Overall, 35 - 60% of carers reported clinical levels of affective disturbance. Higher levels of carer distress were associated with service user difficulties unrelated to psychosis symptomatology. In direct comparisons, carers of voice hearers perceived their relatives to have more severe symptoms of psychosis compared to carers of service users who do not hear voices. No other significant hypothesised differences were found between the groups. An unexpected finding was that carers of those who do not hear voices perceived a greater need to back up the service user compared to carers of those who hear voices. Conclusions: The findings support previous literature documenting elevated mood and stress related disorders in carers of people with psychosis. However they offer minimal support, in the current sample, for the hypotheses that auditory verbal hallucinations differentially impact upon carers’ experiences, illness beliefs, affective states and levels of avoidant coping. The findings underscore the importance of a needs-based framework for improving carer interventions, over a specific approach for voice hearing. Clinical implications and areas for future research are discussed.