OBJECTIVES: To assess the extent and main drivers of healthcare resource consumption in patients admitted with non-variceal upper gastrointestinal bleeding (NVUGIB). METHODS: This observational, retrospective cohort study (NCT00797641; ENERGiB) was conducted in several European countries (Belgium, Greece, Italy, Norway, Portugal, Spain and Turkey). Eligible patients were those consecutively admitted to hospital (1 October -30 November 2008) who underwent endoscopy for overt NVUGIB (haematemesis, melaena or haematochezia, with other clinical/laboratory evidence of acute upper gastrointestinal blood loss). Management of patients proceeded according to routine care at each centre. During a 30-day follow-up period, data on various clinical outcomes were collected from patient medical records. The present analysis reports differences between countries in consumption of healthcare resources. RESULTS: A total of 2661 patients (65% men; mean age 67.7 years) were enrolled. The mean number of days of hospitalisation (standard deviation [SD]) was 8.9 (5.9) days. A wide inter-country variation was observed, ranging from 7.4 (4.9) days in Turkey to 10.8 (7.5) days in Belgium. Empirical treatment for NVUGIB was administered pre-endoscopy in 68.9% of patients (range 35.1% [Belgium] to 88.7% [Turkey]), most frequently proton pump inhibitors (PPIs) (66.0% of patients, ranging from 32.8% [Belgium] to 87.7% [ Turkey]). Therapeutic procedures were performed during endoscopy in 35.8% of patients (range 24.9% [Greece] to 40.6% [ Belgium]). Most commonly performed related procedures were transfusions (any intravenous fluid; 84.6% of patients, range 74.0% [Belgium] to 92.3% [Portugal]) and additional endoscopies (28.7%, range 12.6% [Turkey] to 53.6% [ Belgium]). Treatment for NVUGIB was administered post-endoscopy in 93.2% of patients, most commonly PPIs (92.6%); a narrow inter-country range was observed. CONCLUSIONS: Management of NVUGIB is associated with substantial consumption of healthcare resources in European countries. There is wide variation across Europe; generally, the highest rates of resource utilisation are observed in Belgium and the lowest in Turkey.