OBJECTIVES: Assess the annual number of patients with MCL who relapse or are refractory to first line therapy in selected European countries. METHODS: A systematic literature review, aiming to identify and summarize all evidence related to outcomes of current treatment options for MCL was conducted. A comprehensive literature search of two databases (PUBMED and Cochrane) from 2005-2014, and proceedings from major hematology/oncology conferences was undertaken. In addition, data from various cancer registries, surveillance and cohort studies were analyzed. Incidence and prevalence of MCL was calculated and patient outcomes (e.g. overall response rate [ORR] and progression-free survival [PFS]) were summarized. Data analysis was stratified for subpopulations by age, ECOG performance status and first-line treatment options available in the countries under study (Belgium, France, Germany, Italy, Netherlands, Poland, Spain, Sweden and the UK). RESULTS: The proportion of MCL as a subtype of NHL ranges from 2.0% to 7.1%. Minimum and maximum estimates of the newly diagnosed total patients with MCL in Europe range from 3,219 to 6,177 patients (0.6 – 1.2 per 100,000) in 2012, and the estimated prevalence ranges from 9,014 to 17,296 (1.8 – 3.4 per 100,000). Overall response (OR) rates after first line immunochemotherapy in MCL patients ranges from 63% to 97%, complete response (CR) rates range from 15% to 96%. Progression-free survival (PFS) ranges from 16 months to 83 months. Based on evidence derived from this review, the steady-state prevalence of patients with relapsed or refractory MCL ranges from 1,778 – 8,799 patients annually, requiring second line treatment in the countries under study.  CONCLUSIONS: Despite improved treatment alternatives and improved outcomes in patients with MCL, remission duration is still short and the proportion of patients needing 2^nd line and subsequent lines of therapy is high.