Background: Metastatic lung cancer is the leading cause of cancer-related death in the US. In the last decade, patients (pts) with EGFR mutations have benefitted from improved medical outcomes, including survival, with EGFR-directed targeted therapy. We sought to explore if these improvements in care outcomes might impact the delivery of EOL care in this population. Methods: We retrospectively reviewed medical records of pts at our center diagnosed with metastatic EGFR-mutant lung cancer from January 2009 to December 2012. We limited our review to pts who had at least one cancer therapy at MGH and who died by January 2015. Results: 61 pts were included. 44 pts (72%) were female. 42 pts (69%) received cancer-directed therapy within 30 days of death. Of these 42, 34 pts (81%) received oral chemotherapy, 3 (7%) received IV chemotherapy, and 5 (12%) received oral and IV chemotherapy. 41 pts (67%) were hospitalized within 30 days of death. The median number of total hospitalizations was 2 (0-8) and median number of total inpatient days was 16 (0-88). 24 pts (39%) had a palliative care outpatient visit and 43 (70%) had an inpatient palliative care consult at some point. Prior to death, 34 pts (56%) enrolled on hospice, 19 (31%) were never on hospice, and the hospice status of 8 (13%) was unknown. Of the 53 pts with known hospice status, median length of stay was 6 days (0-206). 33 pts (54%) died at home with hospice or in an inpatient hospice, 18 (30%) died in the hospital, 2 (3%) died at home without hospice, and location of death was unknown for 8 (13%). Conclusions: Pts with EGFR mutations had high rates of hospitalization and chemotherapy use in the last month of life, and many died in the hospital. These rates are higher than rates in the overall lung cancer population in published literature. Additionally, palliative care utilization was high, but only half enrolled on hospice before death. These data suggest that patients with EGFR mutations are receiving more intensive medical and cancer care at the EOL. Further study of EOL care and health service utilization in this unique patient population is warranted.