NICE introduced a fast track appraisal (FTA) process in April 2017 to speed-up access to the most cost-effective new treatments. This study reviews the characteristics of the FTAs completed so far. All NICE technology appraisals since April 2017 were reviewed to determine the appraisal process used. For all FTAs identified, two reviewers independently extracted the draft and final scope wording, appraisal timelines, comparators, and clinical- and cost-effectiveness evidence from publicly-available appraisal documents on the NICE website. Regulatory timelines were extracted from the EMA website. Only five FTAs were identified from 189 published appraisals between 1st April 2017 and 1st March 2020. Time from positive CHMP opinion to final NICE guidance ranged between 25–138 weeks, with a shorter delay for the more recent FTAs. Time from invitation to participate (ITP) to guidance was on average 41 weeks, which is longer than the FTA target of 32 weeks, but still shorter than the single technology appraisal (STA) target of ∼54 weeks. All 5 company submissions included an indirect treatment comparison (ITC); in one case, clinical expert opinion of equal/superior efficacy justified the cost-comparison analysis, despite substantial uncertainty associated with the ITC. All FTAs were cost-comparison analyses – the ICER <£10,000/QALY criteria for FTA eligibility is yet to be utilised. All cost-comparison analyses focused on 1–3 comparators, whilst a wider range of comparators were included in the ITC. The draft scope explicitly welcomed comments on the appropriateness of the cost-comparison methodology for 2/5 of the FTAs. When used, FTA brings faster treatment access to patients, with an average time between ITP and guidance that is 13 weeks shorter than the STA target timeline. However, FTA is rarely used and utilisation needs to increase significantly to bring about a material difference to the speed with which patients access new medicines.