OBJECTIVES: To assess current status of disease control and treatment satisfaction in patients with acromegaly in the United States.   METHODS: A web-based cross-sectional survey was conducted from August –October, 2014.  Acromegaly patient-reported information on treatment satisfaction and preference, symptom control, and comorbidities were collected and analyzed descriptively.  RESULTS: A total of 106 patients completed the survey (mean age: 46 years, female: 76%). Patients had a 5-year diagnosis delay after symptom onset. Most patients (91%) had undergone surgery. Of 68 patients on pharmaceutical therapy: 79% were on somatostatin analogs, 22% on dopamine agonists and 13% on GH-receptor antagonists. Almost half of the patients (47/106) presented with 5 or more comorbidities (depression 57%, hypertension 43%, musculoskeletal and connective tissue abnormalities 42%, sleep apnea 37%, cardiac and cardiovascular diseases 32%, and diabetes 32%). There were 96 (91%) patients reporting acromegaly-related symptoms (e.g. headache, excess sweating, and joint pain). As compared with the low-symptom group 0-3 (n=41), the high-symptom group with 4+ symptoms (n=65) were more likely to have depression (OR=2.33, 95% CI, 1.05-5.19) and cardiovascular disease (OR=5.80, 95% CI, 2.02-16.67). Among patients on injectables (n=61), 61% had worse symptoms toward the end of injection cycle, and 38% requested medical intervention (i.e. additional daily injection, unscheduled injection, or oral medicines). 84% of patients reported that the symptoms interfered with daily life and work; 85% felt frustrated. The treatment satisfaction rate was 56%; 33% didn’t like having injections. The top patients’ preferences for new acromegaly treatments were to avoid injections (e.g., oral formulation) (85%), improve disease management such as patients’ support (62%), and to provide better patient education (57%). CONCLUSIONS: More than 40% of patients were not satisfied with their current treatment for acromegaly. Patients want better therapy (e.g., oral drugs), improved disease management, and education programs.