OBJECTIVES To describe and compare euthanasia and physician-assisted suicide (EAS) practice in Flanders, Belgium (BE), the Netherlands (NL) and Switzerland (CH). METHODS Mortality follow-back surveys among attending physicians of a random sample of death certificates. RESULTS We studied 349 EAS deaths in BE (4.6, 851 in NL (4.6 and 65 in CH (1.4. People who died by EAS were mostly aged 65 or older (BE: 81 NL: 77 71 and were mostly diagnosed with cancer (BE: 57 66. Home was the most common place of death in NL (79, while in BE and CH, more variation was found regarding to place of death. The decision to perform EAS was more frequently discussed with a colleague physician in BE (93 and NL (90 than in CH (60. CONCLUSIONS EAS practice characteristics vary considerably in the studied countries with legal EAS. In addition to the legal context, cultural factors as well as the manner in which legislation is implemented play a role in how EAS legislation translates into practice.