Summary:Background:Febrile neutropenia (FN) is a common side effect of chemotherapy that frequently necessitates hospitalization and healthcare resource utilization (HCRU), but is poorly studied in Eastern European countries. We investigated HCRU and granulocyte colony-stimulating factor (G-CSF) use in patients hospitalized for FN in Bulgaria, Czech Republic, and Slovakia.Patients and methods:This was a multicenter retrospective cohort study. Eligible patients were ≥18 years old, had received chemotherapy for solid tumors or hematological malignancies of any stage, and had been hospitalized for FN. The primary objective was to evaluate FN-related HCRU; secondary objectives included the description of chemotherapy treatment patterns and G‑CSF use. Data were analyzed by participating country.Results:Data of 156 patients from Bulgaria and 79 patients each from the Czech Republic and Slovakia were analyzed. The most frequent solid tumors were breast (n = 28) and testicular cancer (n = 13), and the most common hematological malignancies were non-Hodgkin B‑cell lymphoma (n = 51) and acute myeloid leukemia (n = 35). In general, G‑CSF was used to treat FN rather than as prophylaxis. Most patients had a single FN episode, predominantly in cycle 1. The mean duration of FN-related hospitalization was 7–9 days, with longer stays in patients with hematological malignancies.Conclusions:Results indicate considerable FN-related HCRU in all countries. Frequent lack of G‑CSF primary prophylaxis was observed, particularly in Slovakia.