OBJECTIVES: Cytomegalovirus (CMV) can be transmitted to a developing child during pregnancy. In Germany, seropositivity rate is around 50%, risk of seroconversion during pregnancy 1% and congenital infection resulting from primary infection about 50%. Every year 495 infants will be born with congenital CMV-syndrome and 186 infants are infected but asymptomatic at birth and will develop a multitude of abnormalities (hearing loss, mental retardation etc.) due to primary CMV infection just as well as 750 children from seropositive mothers. The disease burden for affected children and parents is enormous. METHODS: The objective of this study was to estimate the total economic impact (lifetime direct and indirect costs based on deliveries p.a.) on society due to CMV-infection based on incidences. Additionally this study shows the positive monetary impact of screening (serologic testing and treatment in case of primary infection). Direct costs comprise all treatment costs of symptoms appearing at birth or later on. The incidences of sequelae were derived from literature. Indirect costs comprise the changed job situation of parents, work absenteeism, nursing leave, lost human capital of dead people, costs of special schools and nursing homes. The resource use was determined by literature and experts. All costs represent data from 2008. RESULTS: The total discounted costs of CMV infection from a societal perspective were €243m p.a. (941m€ undiscounted), whereas €225m p.a. (€870m undiscounted) are indirect costs corresponding to €766,444 per child (€2.97m undiscounted). Total costs for diagnosis and prevention are €50.43m. CMV screening and treatment of primary infected mothers by CMV specific hyperimmunoglobulin reduce total societal costs to €152m€ (€444m undiscounted) and prevents infection in 640 children. The budget impact amounts to €91m (€497m undiscounted). CONCLUSIONS: CMV-infection causes high disease burden and costs. A screening program is suitable to decrease future costs and disease burden of affected infants and parents.