OBJECTIVES: Neuromuscular disorders (NMDs) are chronic devastating diseases. The objective of this multicenter cross-sectional study was to evaluate cost of illness in three NMD in Germany. METHODS: A cohort of 107 patients with Amyotrophic Lateral Sclerosis (ALS, n=46), Facioscapulohumeral Muscular Dystrophy (FSHD, n=20) or Myasthenia Gravis (MG, n=41) were recruited consecutively in seven centers in Germany. The health-economic data were collected using a “bottom-up” approach consisting of comprehensive questionnaires and patient diaries. Bootstrap 95% confidence intervals were calculated for cost data. Cost-driving factors were identified using multivariate regression analysis with standard errors estimated using a bootstrap technique. Costs were evaluated from the German societal perspective in 2009 Euros (EUR). RESULTS: Total annual costs from the societal perspective were EUR 36,380 (95% CI: 27,090-47,970) per patient in ALS, €26,240 (95% CI: 17,770-37,940) in FSHD and €14,950 (95% CI: 10,470-21,730) in MG. The main components of costs were the expenditures of health insurance and the loss of productivity of patients and their caregivers. Following independent cost-driving factors were identified in ALS: disease severity, assistance in activities of daily living (ADL), dementia and younger age. In FSHD, they were disease severity and assistance in ADL. Cost-drivers in MG were disease severity and assistance in ADL. CONCLUSIONS: Socioeconomic burden of NMDs in Germany is considerable. ALS was associated with highest costs among studied NMDs. Further studies evaluating both the health-economic and clinical effects of NMDs treatment as well as disease-management programs and benchmarking activities are necessary.