BACKGROUND Bevacizumab has been used in first line NSCLC in Europe since its regulatory approval in 2007. Bevacizumab has demonstrated significantly improved survival in  randomized phase III trials. However, no HRQoL outcomes have been reported so far. OBJECTIVES: To investigate the comparative HRQoL of bevacizumab-based therapy versus non-bevacizumab based therapy in 1st line non-squamous NSCLC in two European countries. METHODS: Data were drawn from the Adelphi NSCLC Disease Specific Programme, a large cross-sectional study of consecutively presenting patients in France and Germany in 2010. Physicians provided retrospective information regarding disease status and treatment patterns, with matched patients invited to complete a questionnaire including the EQ-5D and FACT-L instruments. Propensity scoring methods were used to match the two comparison groups on confounding variables including age, performance status and time since diagnosis. A t-test was used to assess the relationship between current treatment and quality of life.  RESULTS: 363 non-squamous patients receiving first line treatment were analysed, of which 132 were currently receiving bevacizumab-based therapy and 231 were currently receiving non-bevacizumab-based therapy. The quality of life scores using the FACT-L instrument (based on the matched samples) were 77.3 for bevacizumab patients (95% CI 73.7 to 81.0) compared with 74.1 for non-bevacizumab patients (95% CI 70.9 to 77.33), p=0.19. The EQ-5D scores for Progression-Free Survival were 0.68 for the bevacizumab group (95% CI 0.63 to 0.74) and 0.66 for the comparative patients (95% CI 0.62 to 0.71), p=0.57. CONCLUSIONS: This real-life pilot study shows that bevacizumab-based therapy does not have any detrimental effect on HRQoL as measured by the EQ-5D and the FACT-L.