OBJECTIVES: Treatment outcomes improved in metastatic colorectal cancer (mCRC) due to the introduction of the monoclonal antibodies (mAb) in combination with chemotherapy. This study described current treatment patterns of chemotherapy and mAbs in clinical practice in 4 EU countries.  METHODS: This cohort study used physician-surveyed data from the LifeLink™ Oncology Analyzer Database for mCRC patients in 4 EU countries (France, Germany, Italy, and Spain). All patients aged ≥21 years at mCRC diagnosis were included. Treatment patterns in 2009 were examined descriptively by lines of therapy. RESULTS: The study sample includes 2,734 mCRC patients (61% male, median age category 61-70 years) with 862, 656, 567 and 649 from France, Germany, Italy, and Spain, respectively. In 1st-line, more patients received FOLFOX-containing regimens than FOLFIRI-containing regimens in Germany (42% vs 30%) and Spain (25% vs 16%), while in Italy and France the reverse was true (Italy: 34% FOLFIRI vs 29% FOLFOX: France: 26% vs 19%). In 2nd-line, more patients received FOLFIRI-containing regimens than FOLFOX-containing regimens in Germany (36% vs 18%), Italy (29% vs 14%), and Spain (34% vs 6%), while similar proportions of FOLFOX and FOLFIRI were used in France (18% vs 15%). In 1st line, Bevacizumab (Bmab) was administered to 44% of patients in Italy, 42% in France, 37% in Germany and 30% in Spain, while Cetuximab (Cmab) use ranged from 14% in Spain to 7% in Italy. In 2nd-line, Bmab was used in 37% of the patients in Germany, 38% in France, 33% in Italy and 30% in Spain while Cmab was used in 30% of the patients in Spain, followed by 26% in Italy, 20% in Germany  and 17% in France.  CONCLUSIONS: FOLFOX- and FOLFIRI–based regimens are common standard of care chemotherapies, and monoclonal antibodies are routinely combined with these chemotherapies.