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Background Alleviating symptoms is a treatment goal for bronchiectasis; however, few studies have explored symptom burden from patient and physician perspectives. This cross-sectional study describes the burden of bronchiectasis symptoms from the perspectives of both.Methods Data were from the Adelphi Bronchiectasis Disease Specific Programme, a cross-sectional survey of patients and their physicians conducted from September 2024-March 2025 in France, Germany, Italy, Spain, and the UK. Surveyed patients aged ≥18 years had a physician-confirmed diagnosis of bronchiectasis (without cystic fibrosis). Surveyed primary care physicians (PCPs) or pulmonologists were responsible for ≥5 patients/month with bronchiectasis. Physicians completed patient record forms and the same patients independently filled out self-completion forms including Chronic Airways Assessment Tests (CAAT). Responses on current symptoms and impact were analysed and stratified by physician-reported exacerbation frequency (0, 1, 2, or 3+ in the past year).Results In total, 59 pulmonologists and 58 PCPs completed 560 patient record forms, and 232 patients filled out self-completion forms.Physicians reported most patients had symptoms, regardless of exacerbation frequency (89.3% of patients with 0 exacerbations up to 100.0% with 3+ exacerbations). The most impactful physician-reported symptoms (by pulmonologists and PCPs) across most exacerbation groupings were excessive sputum production, dyspnoea, and productive cough. Purulent sputum was in the top five symptoms reported by pulmonologists (26.0% of patients without exacerbations and 46.1% with 1 exacerbation), but not PCPs. Both PCPs and pulmonologists reported increased symptom burden with increased exacerbation frequency.Among patients, 87.8% reported medium-to-very high impact of symptoms based on CAAT scores; the highest impact symptoms were cough, mucus and breathlessness. Despite being rated as mild by physicians, 85.6% of patients reported that symptoms had a medium-to-very high impact (figure 1). 31.3% of patients with 0 physician-reported exacerbations, 34.4% with 1 exacerbation, and >60% with 2 or 3+ exacerbations reported high-to-very high impact symptoms (figure 1).Abstract P128 Figure 1Patient-reported impact of bronchiectasis symptoms by Chronic Airways Assessment Test (CAAT) score by physician-reported symptom severity and physician-reported exacerbation frequencyConclusions Patients with bronchiectasis experienced symptoms even if they had no physician-reported exacerbations, and symptom burden increased as exacerbation frequency increased. Most patients reported medium-to-very high impact symptoms even where physicians rated their disease severity overall as mild, highlighting differences in perspectives of symptom burden.