Background: One of the core functions of Cochrane Centres is to disseminate the results of Cochrane reviews. Supporting geographical and cultural areas is the focus of Cochrane Centres, as recognition of the existing variability between countries. However, little is know about these differences. Objectives: Our aim was to explore the differences in review access between Spanish users of Cochrane reviews and the global use of Cochrane reviews around the world, for translated and original version. Methods: We compared the statistics of access to Cochrane reviews from the two main sources for Spain and Iberoamerica: The Cochrane Library (TCL) and La Biblioteca Cochrane Plus (BCP) for the years 2006 and 2007. We compared the list and characteristics of the most accessed reviews in both platforms, as well as the comparison between country data from TCL. Results: None of the 50 most viewed reviews in the BCP for years 2006–2007 ranks among the world’s 50 most viewed reviews in TCL for that same period, showing no overlap between the preferences of users of reviews translated to Spanish and users of TCL. Spanish readers of BCP favoured translated reviews from the Pregnancy and Childbirth CRG (38.5%), while readers of TCL favoured reviews from the Endocrine and Metabolic Disorders CRG (13.7%). Thus, the medical areas of interest also differ between users of TCL and BCP. Conclusions: There are strong differences in the use of Cochrane reviews by country. These differences may be due to cultural and language factors. An in-depth analysis of this issue with broader data collection would allow Cochrane Centres to identify which are the hot-topics that raise the most interest in the users in their area, and help guide the search for motivated new authors of reviews. Also, it would allow to identify those areas that would benefit of additional disseminative actions. The effectiveness of regional actions to promote Cochrane reviews could be increased by taking into account the range of interests of the target population. Regional surveys of TCL and BCP users could inform us about the profile of these users and shape targeted dissemination activities.