OBJECTIVES:  To model the annual impact on hospital costs following the introduction of sugammadex for routine reversal of neuromuscular blockade. METHODS: An economic model reflecting resource use and costs associated with neuromuscular block and its reversal, and residual blockade, was constructed for a typical Greek hospital. Clinical trial data were used to estimate time savings relating to shortened reversal in the operating room (OR) for sugammadex compared to neostigmine and no reversal. Costs of OR time were derived from labor costs for different types of OR staff. Resource use associated with residual blockade sequelae (aspiration, hypoxemia, muscle weakness, upper airway obstruction) was estimated from the literature. Annual procedures, utilization of neuromuscular blocking and reversal agents, and uptake of sugammadex within a typical Greek hospital were estimated.  Unit costs were based on public data sources or published literature. RESULTS: If all OR staff modeled (with average staff attendance across all procedures of 2.4 anesthetists, 3.5 surgeons and 3.7 nurses) can realize time savings with shortened reversal, use of sugammadex is estimated to save a typical Greek hospital, using sugammadex in 7,130 procedures annually, 23,717 € per year. This corresponds to an increase in drug costs of 358,963 €, which is more than fully offset by a decrease in costs of OR staff and clinical sequelae of residual blockade (-382,680 €). In a worst case scenario, if only one second degree anesthetist, one second degree surgeon and one nurse in attendance realize time savings, annual costs would be increased (198,404 €).  Results were sensitive to OR staff costs and time savings. CONCLUSIONS: Sugammadex for routine reversal of neuromuscular blockade can potentially lead to cost savings in the Greek healthcare setting.  The degree to which costs may be saved depends upon which OR staff can realize time savings with shortened reversal.