OBJECTIVES: Acromegaly, a relatively rare chronic endocrine disorder, results from excessive growth hormone (GH) secretion from a pituitary adenoma. Information on treatment practices and burden of acromegaly is limited. This study focused on assessing the burden of disease based on data retrieved from a large series of these patients. METHODS: A retrospective chart audit was conducted in September 2012 in US, France Italy and Brazil. Ninety-seven endocrinologists completed structured case report forms for the 4 most recently-seen acromegaly patients (N=380); those on the last choice of medical therapy ≥6 months ‘qualified’ for this this analysis (N=335).  Patient demographics, comorbidities, treatment history, insulin-like growth factor [IGF-1], random growth hormone [GH]), symptoms and healthcare resource utilization were recorded. Control of IGF-1 was defined as IGF-1≤1ULN, control of GH as GH≤2.5 µg/L.  RESULTS: Fifty-two percent of patients were males, mean age 51 years; 63% with controlled IGF-1; 34% with controlled IGF-1+GH. The prevalence of comorbidities (hypertension, diabetes, arthritis) was similar in patients with controlled vs. uncontrolled IGF-1 and in patients with controlled versus uncontrolled IGF-1+GH. The rate of paresthesia was significantly lower in patients with controlled vs. uncontrolled IGF-1 (10% vs. 23%, p=0.003) and in patients with controlled vs. uncontrolled IGF-1+GH (9% vs. 25%, p=0.015). Utilization of health care resources was similar in patients with controlled versus uncontrolled IGF-1 except for days hospitalized, which were significantly higher for patients with uncontrolled IGF-1 (p<0.05). Patients with controlled IGF-1+GH had significantly lower number of HCP visits, hospitalizations and length of hospitalization than those uncontrolled (p<0.01). In multivariable models predicting resource utilization based on biochemical control and comorbidities, IGF-1+GH control remained a statistically significant predictor of HCP visits, hospitalizations, and days hospitalized (p<0.05). CONCLUSIONS: This retrospective chart audit demonstrated that acromegaly patients with controlled IGF-1+GH have reduced symptom burden and resource utilization than uncontrolled patients.