OBJECTIVES: Describe the treatment patterns of GBM patients in Germany. METHODS: Between January and February 2006, retrospective case histories of 50 adult GBM patients no longer receiving active treatment were provided by 10 physicians from 10 German institutions. RESULTS: Seventy percent of patients were diagnosed in 2004-5. 60% of patients were male; 58% were >50 years old. At diagnosis, patients were classed as fully active (26% with no neurological symptoms; 42% with minor symptoms); 22% were fully active with assistance with moderate symptoms, 6% were less than fully active with moderate symptoms and 4% were disabled with severe symptoms. 49 patients had their initial therapy recorded; all underwent surgery. Subsequently, 39% underwent chemoradiation, 39% radiotherapy, and 14% chemotherapy. Of those undergoing chemoradiation, 94% received temozolomide. Of those undergoing radiotherapy, 53% subsequently received chemotherapy before relapse; 90% received temozolomide either as a single-agent or in combination with doxorubicin. Disease recurrence was documented for 36 of 50 patients, of which 13% had no neurological symptoms, 41% had minor symptoms, 28% had moderate symptoms and were fully active with assistance, and 19% had moderate symptoms and were less than fully active. 42% (15 / 36) were treated with chemotherapy initially for their recurrence; patients received a variety of single-agent or combination regimens of which temozolomide, nimustine, doxorubicin, and teniposide were most common. 53% of these patients received subsequent chemotherapy regimens. 44% (16 /36) underwent surgery initially for their recurrence, with 81% (13 / 16) of these patients receiving subsequent chemotherapy. Other drugs used in treatment of recurrent disease included doxorubicin and lomustine. CONCLUSION: Consistent with published guidelines, GBM patients in Germany with better functional status undergo active therapy. Patients initially undergo surgery, followed by radiotherapy. Chemotherapy is often used with or immediately following radiotherapy or at disease recurrence.