From September 29th till October 2nd, Vienna formed the spectacular background for the annual meeting of the European Society for Medical Oncology (ESMO). It was the third time that Vienna played host to the ESMO Congress, with previous congresses taking place in 1996 and 2004. However, this years’ edition proved to be the biggest and best congress yet with an astonishing 16,394 delegates from all over the world. Given the vast amount of data presented at ESMO 2012, this report does not aim to summarise the entire meeting, but will focus on ten important take-home messages from the meeting, presented during one of the presidential or proffered paper sessions. All abstracts presented during ESMO 2012 can be consulted at (BELG J MED ONCOL 2012;6:176–180)