Introduction Bevacizumab, a VEGF inhibitor, is used off label for treatment of severe anaemia related to epistaxis, GI-bleeding and/or severe liver arteriovenous malformations (HAVM) and right sided cardiac failure in patients with Hereditary Haemorrhagic Telangiectasia (HHT) Aim To report the experience of treatment with bevacizumab within VASCERN centres. Method A retrospective analysis of the usage, availability, efficacy and safety in HHT patients treated with bevacizumab in the European VASCERN centres. Results A total of 151 patients received treatment with bevacizumab in European VASCERN centres. Most patients were treated in Denmark, France and the Netherlands. There was an improvement in haemoglobin with a mean increase of 2.9 g/dL and significant reduction in the number of red blood cells transfusions. Cardiac output was measured and improved in 85 % of patients treated for high output cardiac failure in relation to severe HAVM. No severe adverse events were recorded, however 70 patients experienced at least one side effect. Conclusion Although this is a retrospective study, we have shown convincing efficacy of bevacizumab in treatment of patients with HHT, with a good risk-benefit balance.