Gräsner JT, Wnent J, Herlitz J, et al. - Given a variation in the epidemiology and outcome after out-of-hospital cardiac arrest (OHCA) across Europe, researchers followed on from EuReCa ONE to further determine the incidence of and outcomes from OHCA in Europe. In addition, they sought to enhance the understanding concerning the role of the bystander. Registry-based data over a 3-month period (October 1, 2017, to December 31, 2017) were included in this prospective, multicentre study. Data from all 28 countries, covering a total population of 178,879,118 was gathered. A total of 37,054 confirmed OHCA were reported, with cardiopulmonary resuscitation (CPR) being started in 25,171 cases. Countries varied in the bystander CPR rate ranging from 13% to 82 (average: 58%). ROSC was achieved in one-third of cases (33%) and there were 8% of patients who were discharged from the hospital alive. In cases, where a bystander performed CPR with ventilation, higher survival to hospital discharge was observed, compared with compression-only CPR (14% vs 8% respectively). EuReCa TWO, in addition to enhancing the understanding of the role of bystander CPR within Europe, revealed a large difference in OHCA incidence, characteristics, and outcome, and highlighted the degree to which OHCA is a public health burden across Europe. In this study, there remained unexplained variation and a continuing role of the EuReCa network is suggested in improving the quality management of resuscitation.