OBJECTIVES: To assess the burden of hospitalization in advanced lung cancer patients in France and Germany. METHODS: Oncologists (N=80) and pulmonologists (N=40) actively involved in management of Non small cell lung cancer (NSCLC) in France and Germany were invited to participate in a lung cancer disease specific program. Each consenting physician was asked to complete patient record forms for the next 10 advanced (stage IIIB/IV) lung cancer patients seen in their practice. The study period extended from July to October 2010. Data on hospitalization over the past year was provided by the physicians using the patient chart records. The primary reason of hospitalization and the length of stay (LOS) were reported. RESULTS: Majority of the patients (N=1213) were male (68%), Caucasian (92%), Stage IV (89%), currently on first line therapy (51%) with an average age of 63 years. Hospitalization records were obtained for 93% (n=1133) of the patients among which 30% (n=341) of the patients had one or more hospitalization events in the previous year with an average (SD) LOS of 10 (8) days. The primary cause reported for the 449 hospitalization events were disease symptoms (44%), surgery (20%) and therapy side effects (17%). The LOS for surgery related hospitalization (n=89) ranged from 1-20 days (mean: 8 days). Among patients hospitalized for disease symptoms (n=197) the most frequently reported primary causes were dyspnea (23%), cough (10%) and pain (11%) with average LOS of 13, 12 and 8 days respectively. Among patients hospitalized for side effects (n=75), anemia (24%), febrile neutropenia (8%), febrile aplasia (8%) were most frequently reported with average LOS of 4 days. CONCLUSIONS: Burden of hospitalization due to disease symptoms and treatment related side effects is significant in France and Germany. Innovative therapies effective in alleviation of symptoms and side effects could help significantly in decreasing hospitalization costs.