OBJECTIVES: This study aimed to compare the cost-effectiveness (CE) of Bridion® (sugammadex) with neostigmine and spontaneous recovery (SR) approach in the reversal of neuromuscular blockade (NMB) induced by rocuronium/vecuronium, during anesthesia. METHODS: CE analysis (CEA) was performed by solving back the decision tree that included pathways starting with residual NMB and followed by hypoxia and pulmonary complications defined as “aspiration, atelectasis and/or pneumonia” in patients, in whom NMB was induced by rocuronium/vecuronium. Bridion was compared with neostigmine and SR approach. Primary analysis parameters that were used as denominators in the calculation of incremental CE ratios (ICER) are decreased frequencies of mild hypoxia, severe hypoxia and pneumonia. RESULTS: Frequencies of residual NMB were estimated as 51.2% 44.6% and 0.4% in SR, neostigmine and Bridion groups, respectively. Hypoxia rate was calculated as 27.4% and 11.4% in patients with and without residual NMB. Frequencies of pneumonia were 17.2% and 5.9% in patients with and without residual NMB. Percentage of patients without any complication was found to be 88.0% in Bridion group, while it was 73.8% and 75.7% in SR and neostigmine groups. The costs of complications were 126.45€ and 114.56€ in SR and neostigmine groups, while it was only 34.93€ in Bridion® group. When medication cost was added, the total cost rose to 114.62€ in Bridion® group, which was still lower than the total costs of SR and neostigmine groups. The rate of severe hypoxia was estimated as 7.9% in Bridion® group, while it was 13.5% and 12.7% in SR and neostigmine groups, respectively. Pneumonia was seen in 1.2% of the patients in Bridion® group, while the frequencies of pneumonia were 9.4% and 8.3% in SR and neostigmine groups. CONCLUSIONS: Bridion® was found to be dominant to both SR and neostigmine groups, in terms of decrease in frequencies of hypoxia and pulmonary complications.