OBJECTIVES: To evaluate the socio-economic burden of dengue in Brazil during the 2019 outbreak year. METHODS: The epidemiological data was obtained from the official surveillance system (SINAN) and the hospital information system (SIHSUS). All cases non-hospitalized are considered ambulatory. In order to adjust for under-reporting, expansion factors (EF) of 3.2 for ambulatory cases and 1.6 for hospitalized cases were applied. No under-reporting was considered for dengue-related deaths. To estimate the associated costs of dengue cases treated in outpatient care or hospital settings a previously published multicenter cost study was used. Cost of dengue-related death was calculated using the human capital approach and was discounted at 5%. Since no changes in treatment protocols were made in recent years, we assumed that patterns of resource use did not change, thus we only applied inflation factors to estimate these different costs. RESULTS: In 2019 1.6 million probable dengue cases were reported of which the majority was treated at ambulatory level. 54,507 hospitalizations and 842 dengue-related deaths were notified. Based on reported cases and EF, there were an estimated 4.8 million ambulatory cases and 87,211 hospitalizations. We estimate that 279,102 hospitalization days occurred of which 83% occurred between February and July, corresponding to an average of hospital beds used of 1,277, daily. May was the most impacted month with an average of 2,145 hospital beds per day. Considering the scenario adjusted for under-reporting, the costs would be BRL 1.1 billion (USD 269 million) and 3.0 billion (USD 761 million) from the payer and societal perspective, respectively. CONCLUSIONS: In 2019 dengue has posed a substantial socio-economic burden in Brazil and has probably overloaded hospital resources reaching a peak during influenza circulation. Effective hospital resource management is critical to face other outbreaks as the recent SARS-CoV-2 one, which circulate during the dengue and influenza season.