We conducted a retrospective medical record review of 1,063 patients to examine patient characteristics and treatment patterns among adults with Philadelphia chromosome and/or BCR-ABL-positive chronic-phase chronic myeloid leukemia in the USA, UK, Germany, and Japan. Patients who were included received first-line treatment with imatinib between 1 January 2005 and 31 December 2009 and were not enrolled in a randomized clinical trial between first-line treatment initiation and end of recorded follow-up. The average age was 55 years; 60% were male. On average, patients were initiated on imatinib 2.7 months post-diagnosis and received therapy for 22 months [19 months (USA) to 25 months (Japan)], at a median dose of 400 mg/day. Thirteen percent [8% (Japan) to 16% (UK)] had dose escalation to a median 800 mg/day. Twenty-nine percent discontinued imatinib, primarily due to resistance or disease progression. Among 148 patients receiving second-line dasatinib and 113 receiving nilotinib, a greater proportion in the USA and Germany received nilotinib (54% in each country), while fewer patients in Japan and the UK received nilotinib (47 and 17%, respectively). On average, patients had second-line therapy initiated 25 months post-diagnosis and received treatment for 11 months (dasatinib) or 8 months (nilotinib). Patients initiating dasatinib had more advanced disease than those initiating nilotinib.