The Paterberg was included in the Tour of Flanders every time since its first inclusion in 1986, a record it shares only with the Kwaremont. Until 2011 it was usually part of a trio of climbs in the race trajectory, located in between the Oude Kwaremont and Koppenberg, but far before the finish. Since 2012 it is the ultimate climb of the Tour of Flanders, as part of the restyling of the race. Riders needed to climb the hill three times in 2012 and 2013 and two times as from 2014. Because of its place as ultimate difficulty, it often marks the decisive site of the race.