In the past fifteen years, cross-border mergers and acquisitions have had an ever increasing role in the process of bank internationalization. Although a consensus view has developed on the determinants of a bank’s decision to expand abroad and on the determinants of the patterns of expansion, the debate on the consequences of foreign bank presence is still open. The aim of this chapter is twofold. Firstly, it discusses the major results of the empirical literature studying the determinants, the patterns, and the consequences of bank foreign expansion. Secondly, it studies whether the determinants of bank foreign expansions have changed through time, estimating an econometric model of the patterns of cross-border bank M&As between 1990 and 2006.