Abstract Background Mobile health technologies have the potential to revolutionize healthcare delivery and patient engagement. This study explores public attitudes toward health app usage and data sharing across eight European countries, addressing a significant gap in understanding the public’s perspective on mHealth adoption. Methods A cross-sectional survey was conducted involving 6,581 participants from Italy, the Netherlands, France, Germany, Spain, Poland, Romania, and Hungary. The survey assessed current health app usage, future interest, willingness to share health data, and concerns about data privacy and security. Results 21.87% of respondents currently use health apps, with 42.71% expressing interest in future use. Regarding data sharing, 52.82% are willing to share health data with healthcare providers, and 25.48% would share data with research institutions. However, 53.18% fear unauthorized use or hacking of their health data. Significant generational and geographical differences in mHealth engagement were observed, with older generations showing higher willingness to adopt health apps OR 1.22 (CI 1.03 - 1.46) for Baby Boomers, OR 1.45 (CI 0.97 - 2.16) for Silent Generation. Education level emerged as a crucial factor, with tertiary-educated individuals more likely to use health apps (OR 1.41 CI 1.24 - 1.58) and demand transparency (OR 1.61 CI 1.45 -1.78). Conclusions The findings underscore the need for targeted strategies to enhance digital literacy, ensure data privacy, and promote equitable access to mHealth technologies across Europe. Policymakers and healthcare stakeholders should prioritize these areas to foster greater public trust and engagement in mHealth, ultimately improving health outcomes and patient care. Key messages • Public attitudes toward mHealth vary significantly across generations, countries, and education levels in Europe. • Addressing data privacy concerns and enhancing digital literacy are crucial for widespread mHealth adoption.