OBJECTIVES: To describe demographics, treatment patterns and outcomes of patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmon­ary hypertension (CTEPH) treated under everyday practice. METHODS: Retrospective chart review of PAH (N=285) and CTEPH (N=120) patients treated with endothelin receptor antagonists, prostacyclin analogues or PDE-5 inhibitors between July 2003 and June 2009 in specialized centers in 6 countries (France, Germany, Italy, Spain, Sweden, and United Kingdom). Data were extracted from patient files and analyzed descriptively. For survival analysis, Kaplan-Meier estimates were used. RESULTS: PAH patients (idiopathic 49.8%, mean age 55.3±15.6 years, 74.4% females, 6-min-walk-distance [6-MWD] 328±121 meters, NYHA class II/III/IV in 20/66/14%) and CTEPH patients (83.7% inoperable and 15.8% persistent after surgery, 67.5±12.1 years, 60.0% females, 6-MWD 298±120 meters, NYHA II/III/IV in 27/58/15%). Mean pulmonary arterial pressure was 50±16 mmHg in PAH and 45±11 mmHg in CTEPH. Mean pulmonary vascular resistance was 939±760 dyn*s*cm-5 in PAH and 797±726dyn*s*cm‑5 in CTEPH. At baseline, 93.7% PAH patients received monotherapy (bosentan 47.0%, sildenafil 35.8%), with concomitant diuretics (40.0%) and anticoagulants (30.2%). CTEPH patients received monotherapy in 99.2% (bosentan 56.7%, sildenafil 34.8%), with concomitant diuretics (59.2%) and anticoagulants (62.5%).  Mean observation time was 2.2 years (PAH) and 2.1 years (CTEPH). At end of observation, in the PAH group mean 6-MWD increased by 32±91 meters and by 30±90 in the CTEPH group. In the PAH group, 29.1% of patients improved, 63.8% were unchanged, 7.1% deteriorated in the NYHA class, and 20.4% died (annualized death rate 10.3%); in the CTEPH group 32.2% improved, 59.3% were unchanged, 8.5% deteriorated, and 13.3% died (annualized death rate 6.4%).  CONCLUSIONS: These data reflect real-life treatment patterns in PAH and CTEPH patients in a period when several new PAH-specific treatments were introduced. Overall, drug utilization was similar in PAH and CTEPH patients (although off-label in the latter group). In view of outcomes there still a great unmet need, especially for patients with CTEPH.