OBJECTIVES This analysis was intended to identify trends in Hormone Replacement Therapy (HRT) use in female seniors on public drug programs in 5 Canadian provinces between 2001-2002 and 2006-2007. METHODS Claims level data were analyzed for female seniors on public drug programs in Alberta, Saskatchewan, Manitoba, New Brunswick and Nova Scotia. The analysis included calculation of the proportion of female seniors on these programs using HRT, and also examined trends in the dosage and type of therapy used. RESULTS The rate of HRT use among female seniors in the 5 provinces dropped from 13.9% in 2001-2002 to 5.2% in 2006-2007. The decrease in combination HRT use (24.9% per year) was greater than the decrease in estrogen only HRT use (14.7% per year). The vast majority of female seniors still using HRT in 2006–2007 were on estrogen-only regimens (84%). Of women using the higher (0.625 mg) dose in 2001–2002 and still using HRT in 2006–2007, 37% had switched to the lower (0.3 mg) dose. CONCLUSIONS This analysis provides insight into how new evidence affected HRT use in Canadian female seniors. The decline in HRT use observed was consistent with the results of other studies examining use during this time period. The majority of women still using HRT at the end of the study period were on estrogen-only regimens, with over a third of these women using a lower dose.