Background: Standard treatment for aggressive NHL (aNHL) is R-CHOP in B cell lymphomas and CHOP in T cell lymphomas. A significant proportion of patients; however, ultimately die from their disease. To improve outcomes, novel chemotherapy combinations, dosing schedules and strategies have been used. We describe 136 patients with untreated aNHL treated with infusional dose adjusted EPOCH (DA- EPOCH) chemotherapy +/- R in the first line setting. Methods: We screened 138 patients using the tumor registry. Inclusion criteria included diagnosis of aNHL and first line treatment with EPOCH +/-R given from 2005-2013. Exclusion criteria: primary CNS lymphoma and CTCL not requiring therapy. Results: 136 patients met inclusion criteria. 112 (82%) B-cell and 24 (18%) T-cell NHL. 102 (75%) patients were stage III/IV and 34 (25%) were stage I/II. The median duration of follow up was 27 months and 62 (55%) patients completed six or more cycles. The ORR was 82%. 90 patients achieved CR, (76 B-cell and 14 T-cell); 21 with PR (16 B-cell and 5 T-cell). Using Kaplan Meier estimates, RFS at 1, 3, and 5 years was 68%, 63%, and 52% with 95% CIs [0.59,0.85], [0.54,0.70], and [0.31,0.70], respectively. Of the 136 patients, 65 were dose adjusted per guidelines. 10 (7.4%) died within 30 days of completing treatment and 50 (37%) had at least one cycle of therapy delayed. From univariate logistic regression models predicting death, progression, or relapse at two years, patients with T-cell NHL had increased risk of an event [95% CI = 1.4, 8.8] compared to B-cell NHL. Dose adjustment, delay of chemotherapy, unplanned hospitalization and hematologic or non-hematologic toxicity were not associated with risk of an event with 95% CIs [0.29,1.2], [0.45,1.9], [0.37,1.5], and [0.58,2.4] respectively. In multivariate analysis, current smoking, vincristine capped and need for second line therapy were independent predictors of death or relapse. Conclusions: Our data suggests EPOCH+/-R is active in both B and T aNHL. Toxicity did not significantly delay treatment or negatively impact outcomes. Dose adjustment by nadir had no impact on outcomes.