Across continental Europe, the use of DES was widespread during the 1950s to 1970s. A survey found that DES had been prescribed in 18 European countries, except for Sweden and Hungary. The heaviest usage was reported in France, the Netherlands, and Great Britain. France had an estimated 160,000 women exposed in utero, while the Netherlands saw 189,000–378,000 affected pregnancies between 1947 and 1975. Other notable users included Belgium, Spain, Portugal, Ireland, Germany, and Czechoslovakia.

In most countries, DES was promoted as a preventive measure for women with prior miscarriages or risk factors and sometimes even given without specific medical indications. Peak DES usage in Europe occurred in the late 1960s to early 1970s, slightly later than in the U.S. This delay meant that awareness of DES's ineffectiveness and dangers also lagged in Europe.

Some countries continued using DES until the late 1970s or 1980s. Ireland notably opened a dedicated DES clinic in Dublin in 1990 to follow up with DES-exposed mothers and children. Overall, hundreds of thousands of Europeans were exposed to DES, leading to international health repercussions.