OBJECTIVES: Primary biliary cirrhosis (PBC) is an auto-immune disease in which the bile ducts in the liver are slowly destroyed. The objective of this study is to examine drivers of hospital utilization in patients diagnosed with PBC. METHODS: A retrospective descriptive study was conducted on a cross-section of PBC discharges in the MedAssets health system data for inpatient (N=1238) and outpatient (N=6043) visits from October 2015 through September 2016. Multivariable logistic regression was used to identify significant drivers of inpatient admission and mortality. RESULTS: The sample included 4028 unique patients from 285 hospitals. The population was predominantly female (89.0%) with an average age of 61.7 years and average Charlson comorbidity score of 2.8. The most common comorbid conditions were diabetes (19.1%), chronic pulmonary disease (19.0%) and renal disease (13.9%). Only 17% of patients were admitted as an inpatient, however the average length of inpatient stay was 7.3 days and the average cost of inpatient admissions was $16,697. In the inpatient population 4.7% expired during the hospital stay. Hepatic encephalopathy (OR=7.3, p<.0001), myocardial infarction (6.0, p<.0001), portal hypertension (OR=5.7, p<.0001), osteoporosis (OR=3.7, p<.0001), and plegia (OR=3.6, p=.0016) were the largest predictors of inpatient admission. The largest predictors of mortality included hepatic encephalopathy (OR=13.9, p<.0001), old myocardial infarction (OR=9.2, p=.0304), cerebral vascular accident (OR=3.4, p=.0018), and renal disease (OR=3.1, p=.0004). CONCLUSIONS: Patients diagnosed with PBC have a large number of comorbidities and complications, particularly chronic conditions. Improvements in disease management may lead to better patient outcomes and a reduction in hospital utilization and healthcare costs.