OBJECTIVES: Epidermolysis Bullosa (EB) is a group of rare genetic diseases that affects 20 out of every million live births in the United States. Although there are many different variations of EB all have extremely fragile skin that blisters and tears with only minor friction or trauma. EB may also affect internal organs and body systems. The objective of this analysis is to describe EB patients utilizing acute care hospital services and examine drivers of utilization. METHODS: A retrospective descriptive study was conducted on a cross-section of EB discharges in the MedAssets health system data for inpatient (N=114) and outpatient (N=866) visits from October 2015 through December 2016. Multivariable logistic regression was used to identify significant drivers of inpatient admission. RESULTS: The sample included 431 unique patients from 111 hospitals with an average age of 22.0 years. The population included slightly more females (53.4%) than males and had few comorbidities with an average Charlson comorbidity score of 0.76. The most common comorbid conditions were chronic pulmonary disease (14.4%) and renal disease (10.7%). Disease complications included anemia (24.2%), nutritional deficiencies (12.8%), feeding difficulties such as dysphagia or esophageal obstruction (12.0%), skin infections (5.2%) and other infections (6.0%) such as pneumonia and sepsis. While 26.8% of the sample had a single visit during the study period, 4.8% had five or more visits. Utilization was primarily outpatient (88.4%). The average inpatient length of stay was 11.8 days with average cost $43,309. The largest predictors of inpatient admission were skin (OR=7.8, p<.0001) and other infections (OR=28.8, p<.0001), diabetes with complications (OR=8.1, p=.0302), and nutritional deficiencies (OR=5.1, p<.0001). CONCLUSIONS: EB patients have few non-disease related comorbidities but many disease related complications. Hospital utilization is primarily outpatient based, however disease complications may lead to lengthy and costly inpatient admissions.