OBJECTIVES Edaravone (Radicut®), which was first approved in Japan in June 2001 as a free radical scavenger, is used widely for the treatment of acute ischemic stroke in Japan. The purpose of this study was to estimate the economic impact of edaravone therapy in Japan based on results of a meta-analysis of edaravone therapy for patients with lacunar infarction. METHODS Japanese patients with lacunar infarction aged 35 years or older were included in this analysis. We compared the economic impact of treatment for lacunar infarction between the edaravone group (E group) and the non-edaravone group (non-E group). For the basic information on patient status for this analysis, we used previously published meta-analysis data on the modified Rankin Scale (mRS) distribution 1 month or more after the occurrence of lacunar infarction. Four types of costs were considered: hospitalization costs for lacunar infarction therapy, nursing-care costs after hospital discharge, and productivity costs during hospitalization and due to work loss. RESULTS The total costs per patient with lacunar infarction in the E and non-E groups were US$42,054 (1US$=92 JPY) and US$47,270, respectively, and the potential cost savings for using edaravone therapy was estimated at US$5,216. The breakdown of total costs in the E and non-E groups, respectively were for hospitalization costs: US$10,215 (24.3%), and US$8,150 (17.2%), nursing-care costs: US$14,779 (35.1%), and US$18,256 (38.6%), decreased productivity costs due to hospitalization: US$1,956 (4.7%), and US$2,065 (4.4%), and those due to work loss: US$15,105 (35.9%), and US$18,691 (39.5%). CONCLUSIONS In this analysis, edaravone therapy for patients with lacunar infarction was ultimately a promising cost saving therapy compared with other therapies that did not use edaravone, as it avoided nursing-care costs and productivity loss despite being more expensive during acute treatment.