Introduction: Primary Clostridium difficile infection (CDI) is commonly complicated by recurrent CDI (rCDI). Current treatment guidelines rely on clinical differentiation between rCDI and new primary infections, but definitions vary on timing and relatedness of events after index infection. We use a clinically validated diagnostic code-based case finding tool to examine timing of rCDI relative to the index infection in a large population of inpatients and outpatients. The current standard definition for rCDI is recurrence between 14 and 56 days from an index infection. We sought to capture events within this time frame and also beyond to one year. Methods: A retrospective cohort study was performed using the OptumLabs administrative data warehouse, which includes administrative data. Data between 1/1/2005 and 12/31/2016 were extracted from adult patients with medical and pharmacy coverage for at least 12 months prior to CDI diagnosis. Cases were identified using a validated case finding algorithm to identify index and rCDI. Recurrence was defined as an event meeting the case definition and occurring ≥ 14 days and ≤ 365 days from index event. Time to recurrence and total number of recurrence episodes were recorded. Results: Overall, 26,013 index cases of CDI were identified. 5,496 patients (21.1%) developed at least one episode of rCDI. Amongst these patients, 1526 (27.8%) had two or more episodes of rCDI. In patients with a single recurrence, the median time to recurrence was 37 days and the interquartile range for the 25th-75th percentile was 22-78 days. 1334 (33.6%) events occurred >56 days from index infection. In patients with 2 or more recurrences, the median time to recurrence was 32 days and the interquartile range for the 25th-75th percentile was 21-60 days. 398 (35.3%) events occurred >56 days from index infection. Conclusion: Using a validated case finding model to assess timing of recurrent CDI in a large patient population shows that there is significant inter-event heterogeneity in the timing of recurrence events. Many patients have recurrent CDI beyond 56 days and would be misclassified based on current epidemiological definitions.