OBJECTIVES: Cushing’s disease (CD) is an extremely debilitating endocrine condition caused by an adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma. CD has a significant impact on patients’ health, as well as on their physical, cognitive, emotional, and social well-being. Treatment of CD is complex involving surgery, radiotherapy and medication; however, there are limited published real world data on treatment patterns. METHODS: A retrospective database analysis study using CPRD linked with Hospital Episode Statistics (HES) was conducted. Patient population included patients enrolled after January 1956 up to March 2012 with at least two CD diagnosis or Cushing’s Syndrome diagnosis and one of the following: transsphenoidal surgery, benign pituitary neoplasm or pituitary disorder. Data was collected from 510 general practitioners (GPs). Patients’ characteristics, treatment history, and comorbidities were analysed. Cortisol values (urinary free or serum) were expressed as ULN-fold based on patient specific lab norms. Standardized Mortality Ratio (SMR) was calculated and compared to general age/gender matched UK population. RESULTS: 258 patients with CD were identified (227 alive and 31 dead) ). Among alive patients, mean age (SD) was 54(15) years old, 76% female, mean age at diagnosis was 38(15).  Comorbidities were: infections (63%), hypertension (47%), fractures (30%), depression (25%), diabetes mellitus (22%), osteoporosis (22%) and obesity (18%). 65% of patients had treatment records. Among those: 48% received TSS, 41% adrenalectomy, 24% radiotherapy and 42% oral medications. 32% of 1stline TSS and 34% of 1stline radiotherapy patients received further treatment. 26% of adrenalectomy patients were treated with radiotherapy and/or surgery for Nelson’s syndrome. Among patients on oral medications, majority received metyrapone (79%) or ketoconazole (32%). 69% of patients with cortisol measurements (n=92) were not controlled. SMR was 7.4, 5.1 and 3.1 at 5, 10 and 15 years respectively. CONCLUSIONS: This study demonstrated significant mortality and morbidity burden of CD in the UK primary practice.