Combination of standard chemotherapy with rituximab led to improved disease control in patients with B cell lymphoma in clinical trials. We wanted to know if a similar benefit could be demonstrated in the routine data of a regional population-based cancer registry. We searched the registry of the Regensburg Tumor Center for B cell non-Hodgkin lymphomas diagnosed between 1998 and 2006 and compared overall survival of patients receiving any first-line chemotherapy with or without rituximab. Comparing registry data to death certificates, an 86% coverage within the registry was estimated. In the aggressive lymphoma group, 133 patients received rituximab-containing chemotherapy resulting in a 5-year survival of 69.6%, whereas 205 patients received chemotherapy alone with a significantly inferior 5-year survival of 56.8%. First-line chemotherapy with rituximab in 81 patients with indolent lymphoma also led to improved 5-year survival compared to 134 patients without rituximab (69.7% vs. 51.8%), primarily observed among patients with follicular lymphoma (84.7% vs. 52.0%). These data confirm the standard use of rituximab as first-line therapy in diffuse large B cell lymphomas as well as in indolent lymphoma. Furthermore, they support the collection of treatment data including detailed information on systemic therapy in cancer registries to be used for outcomes research.