OBJECTIVES: To evaluate the clinico-pathological characteristics and treatment pattern in metastatic breast cancer (MBC) in tertiary care hospital. METHODS: A retrospective study was conducted using patient medical records diagnosed with metastatic breast cancer from January 2006 to December 2010 and were analyzed for clinico-pathological characteristics and treatment patterns. Demographic data along with socio-family history, hormonal receptor status, HER2/neu status, menopausal status, distant metastasis and treatment were recorded. RESULTS: The study included 152 MBC patients, which showed that the majority was seen in age-group 25 to 50 years, and the number of postmenopausal women was the most observed. Among them there was equal distribution of both estrogen receptor (ER) positive and negative patients, while progesterone receptor (PR) negative patients were more when compared to positive. HER2/neu status was available in 74 patients, among them 32.4% were strongly positive, 35.1% patients were weakly positive and 32.4% were negative. Reports on organ metastasis were available for 146 patients, among them majority (37.1%) had bone metastasis followed by liver metastasis (19.8%). The treatment of MBC mainly included systemic chemotherapy and/or hormonal therapy. Palliative radiotherapy was given to 59.2% of patients. Anthracycline based chemotherapeutic regimens (AC, FAC, CEF) were prescribed the most common (88.9 %). Taxanes and capecitabine were prescribed as second line agents. However, aromatase inhibitors (1 mg once daily anastrazole, 2.5 mg once daily letrozole, and 25 mg once daily exemestane) were prescribed mainly as sequential or extended therapy. Bisphosphonate (monthly 4mg zolendronic acid) were prescribed among 30.7% of patients. The symptomatic treatments included opiates, antiematics, dexamethasone, antidepressant, laxatives, lidocaine, iron and calcium supplements. CONCLUSIONS:  This study highlights the epidemiological, clinico-pathological characteristics of MBC and its treatment pattern in a tertiary care hospital in South India.