OBJECTIVES: Ebstein’s anomaly (EA) is a rare congenital heart disorder affecting the tricuspid valve in approximately one out of every 200,000 live births.  Treatment for EA is focused on reducing symptoms and avoiding disease progression to complications like heart failure or arrhythmia.  The objective of this analysis is to examine hospital-based utilization in patients with EA. METHODS: A retrospective cross-sectional study was conducted on EA discharges in the MedAssets health system data for inpatient (IP) and outpatient (OP) visits between January 2009 and December 2014. Age and gender, hospital characteristics, clinical comorbidities and measures of utilization including length of stay (LOS) and readmissions were described. Multivariable regression was used to identify significant drivers of hospital-based utilization. RESULTS: Hospital utilization occurred primarily in the OP setting (81.0%) in teaching facilities (88.3%) with 300 or more beds (78.1%). More than half the population was female (56.0%) with a mean Charlson comorbidity score of 0.43.   Mean age was 21.6 years with 55.7% under the age of 18. The most common OP procedures were diagnostic (10.3%) while valve and septa operations (15.6%) and heart catheterization (11.9%) were the most frequent IP procedures.  Mean LOS was 10.4 days.  Congestive heart failure (CHF) (RR 1.31, 95% CI 1.12, 1.51) fluid and electrolyte disorders (ED) (RR 1.68 CI1.46, 5.74), and ventricular septal defects (RR 1.33, CI1.09, 1.62) diagnoses were associated with longer IP stays.  5.0% of patients admitted expired in the hospital and 8.5% were readmitted within 30 days. CHF (OR 2.26 CI 1.10, 5.12), ED (OR 3.51 CI 1.49, 8.62), and cardiac dysrhythmias (OR 2.63 CI 1.22, 8.62), were associated with increased mortality.  Only CHF (OR 2.64 CI 1.46, 4.68) was associated with increased readmissions. CONCLUSIONS: While EA patients are typically treated in the OP setting hospital utilization is high when IP services are required.