BACKGROUND: This study examined demographic profile, continuation rates and reasons for removal among Implanon users accessing two family planning clinics in Queensland, Australia. STUDY DESIGN: A retrospective chart audit of 976 women who attended for implant insertion over a 3-year period between May 2001 and May 2004. RESULTS: Continuation rates showed that at 6 months after insertion, 94% of women continued, 74% continued at 1 year and 50% continued at 2 years. Metropolitan women were more likely than rural women to discontinue use because of dissatisfaction with bleeding patterns. Cox regression analysis showed that those attending the regional clinic experienced significantly shorter time to removal. CONCLUSIONS: Implanon continuation rates and reasons for removal differ between clinics in metropolitan and rural locations. A cooling-off period did not affect the likelihood of continuation with Implanon. Preinsertion counselling should emphasize potential changes in bleeding patterns.