OBJECTIVES: To examine the methodological quality of economic evaluation studies in obstetrics, gynaecology and reproductive medicine published from 1997 to 2008 and compare it with studies published between 1990 and 1997. METHODS: A checklist was constructed by using several existing checklists for methodological quality of economic evaluations and consisted of 30 quality criteria. Each of the articles was reviewed independently by two reviewers. Literature searches were performed in 23 obstetrics, gynaecology and/or reproductive medicine journals in Medline for the years 1997 through 2007. The following search strategy was used: “Cost-Benefit analysis”(Mesh) OR “Cost-benefit” OR “Cost-effectiveness”, and "Costs and Cost Analysis"[Mesh]. This search resulted in 615 articles concerning an economic analysis. Letters, comments, reviews and no full economic evaluations were excluded. The quality of studies was compared to a similar study that reported on the period 1990 through 1997. RESULTS: In our review 155 articles from 12 journals were included. The majority of the studies (57%) concerned obstetrics, whereas 37% dealt with gynaecology and 7% dealt with reproductive medicine. Most articles reported cost-effectiveness (55%), whereas 8% concerned cost-utility analyses. The mean number of criteria adhered to was 16.7 out of the 30 items. Highest score was met for the criteria ‘description of competing alternatives’ (95%). Only 16% of all the studies reported the perspective of the analysis, which is comparable to a previous review (19%). The primary outcomes are clearly stated in 92% of the studies, and that is better than in the earlier review (72%). More incremental (57% vs. 17%) and sensitivity analyses (66% vs. 21%) were reported as well. CONCLUSIONS: The methodological quality of economic evaluation studies published during the last decade in obstetrics, gynaecology and/ or reproductive medicine journals considerably improved since an earlier review reported over the years before. However, improvement is still needed on several topics.