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Introduction Chronic eosinophilic pneumonia (CEP) is a rare condition associated with pulmonary and blood eosinophilia. Treatment to date has primarily comprised of prolonged courses of oral corticosteroids. Despite this, relapses are common and patients can often require treatment with recurrent courses or even maintenance oral steroids (mOCS) which is associated with significant morbidity. Limited data exists on the clinical effectiveness of eosinophil depleting biologic therapies in this patient cohort. Herein we report on our real-world experience utilising the anti-IL5R mAb benralizumab in patients with CEP.Methods We performed a retrospective analysis of patients with severe eosinophilic asthma with a co-existing diagnosis of CEP who received treatment with benralizumab at our severe asthma centre. CEP was diagnosed on the basis of CT evidence of subpleural consolidation in association with blood hyper-eosinophilia and exclusion of other causes. Baseline clinical characteristics and clinical outcomes at 1 year were evaluated. Data on the long-term CEP relapse rate was also collected.Results 12 patients (58% female) with CEP were identified. The mean (SD) time from CEP diagnosis to biologic initiation was 32 (21.7) months. The mean (SD) number of CEP relapses prior to mAb initiation was 2.3 (1.8) which improved to 0.72 (1.3) (p=0.03) following mAb initiation with 83% patients having no CEP relapses. Median (IQR) BEC fell from 4.0 (1.7–4.7) to 0 (0–0) with benralizumab (p = 0.002). At baseline 83% of patients required mOCS primarily for relapsing CEP, with a mean dose of 14 mg (12.3). After 1 year, 60% of patients were able to discontinue mOCS therapy with only 4 patients requiring mOCS, all for adrenal insufficiency (p=0.004).Conclusion Treatment with benralizumab resulted in a significant reduction in the rate of CEP relapse. In addition, there was a significant reduction in oral corticosteroid requirement with no patient requiring mOCS for CEP after 1 year of treatment. These findings support the use of eosinophil depletion with benralizumab as an effective steroid sparing treatment for patients with CEP.