Background: Acromegaly is associated with significant morbidity. The purpose of this study was to establish characteristics and outcomes of patients treated for acromegaly at The Ottawa Hospital, to compare our results with published reports from other centers and to identify opportunities to improve patient care. Methods: A retrospective chart review of patients surgically and medically treated for acromegaly between January 1, 2007 and December 31, 2016 was completed. Demographic information, biochemical data, presenting features, disease comorbidities, treatment interventions, and were collected. Results: Fifty-one patients were identified using CCI/ICD-10 codes and IGF-1 levels. Similar to other centers, the majority of patients had a macroadenoma (78.4% vs 11.8%) with a high percentage invading the cavernous sinus (57.5%). While surgical intervention was performed in 90% of patients, only 23.3% of patient achieved surgical cure (IGF-1 normalization within reference range). Approximately 30% of patients were controlled with adjuvant medical therapy while more than 40 % had elevated IGF-1 levels at last follow-up. Radiotherapy was less commonly used. Conclusions: Despite a multi-modal treatment approach for acromegaly, outcomes are variable. This study highlights the need for further research to better understand factors associated with surgical cure, response to medical therapy and the role of radiotherapy.