OBJECTIVES: To explore use of electronic medical records (EMR) for identifying drivers of all-cause healthcare resource utilization and factors associated with increased resource use in patients with fibromyalgia (FM). METHODS: This retrospective analysis used structured de-identified EMR data from the Humedica database including demographics, clinical characteristics, healthcare resource utilization, and prescriptions. Adults (≥18 years) with FM were identified based on ≥2 ICD-9 codes for FM (729.1) ≥30 days apart between January 1, 2008 and December 31, 2012, and were required to have ≥12 months continuous enrollment pre- and post-index; the first FM diagnosis was the index event. Multivariate analysis using generalized linear models evaluated how demographic and clinical characteristics relate to 12-month post-index resource utilization.  RESULTS: Patients were predominantly female (81.4%), Caucasian (87.7%), with a mean±SD age of 54.4±14.8 years. Primary drivers of resource utilization were “medication orders” and “physician office visits,” used by 91.6% and 87.5% of patients, respectively, with 12-month post-index means of 21±21.5 drug orders/patient and 15.1±18.1 office visits/patient, the latter accounting for 73.3% of all healthcare visits. Opioids were the most common prescription medication, 44.3% of patients. The chance of being a high healthcare resource utilizer was significantly increased (p<0.001) 1.26-fold among African-Americans relative to Caucasians and for patients with specific comorbid conditions ranging from 1.06-fold (musculoskeletal pain and depression/bipolar disorder) to 1.21-fold (congestive heart failure). Similarly, factors significantly (p<0.001) associated with increased number of medications ordered included being female (1.23-fold) and the presence of conditions such as sleep disorders (1.08-fold), depression/bipolar disorder (1.07-fold), and anxiety (1.06-fold). CONCLUSIONS: Physician office visits and pharmacotherapy were drivers of all-cause healthcare utilization; opioids were the most commonly prescribed medication class. Comorbid conditions were key factors associated with high resource use. EMR can be a useful tool for identifying and potentially managing FM patients with high healthcare resource utilization.