OBJECTIVES: Incorrect use of colony stimulating factors (CSF) can add unnecessary cost to cancer treatments and adverse events to patients. We conducted an epidemiological study to assess the correlation between CSF use recommendations issued by the Brazilian Regulatory Agency of Health (ANS) and technical recommendations stated by international guidelines. We also analyzed the main reasons for not recommending the use of CSF, in patients during chemotherapy.  METHODS: Data on patients treated with CSF during 2014 was retrieved from Evidências - Kantar Health database of administrative claims, which comprises more than 4 million people and 46 Private Health Insurance Companies (PHIC) in Brazil. Demographic assessment, types of tumor, number of patients, treatment purpose, technical recommendation, ANS recommendation, reason for not recommending and class of requested CSF were assessed. RESULTS: We retrieved 440 CSF requests corresponding to 322 patients. 188 requests were recommended both technically and by ANS. In 200 claims, CSF use was not recommended by either guidelines or ANS; and only 30 claims were in discordance, as CSF use was recommended by guidelines but not by ANS. Reasons for technical non-recommendation were: requests for primary prophylaxis on chemotherapy regimens with risk of febrile neutropenia below 20% and no complicating factors (37.5%), secondary prophylaxis in palliative care setting (26%) or request based on complete blood count (CBC) collected at the nadir of chemotherapy. CONCLUSIONS: Administrative recommendations from ANS are in close agreement with the scientific literature. Nevertheless, despite clear international guidelines and ANS recommendation, there is still a gap in physicians’ knowledge about the correct indications for CSF. Continual medical education on this topic should emphasize the following of protocols to ensure proper CSF use.