Introduction:Inappropriate shocks are the most common complications of ICD, causing a negative effect on patients’ morbidity and mortality. Little is known with regards to the cost associated to the management of inappropriate shocks. The aim of the study was to determine inappropriate shocks related factors and to evaluate its associated hospital cost.  Methods:All patients implanted with an ICD were retrospectively analyzed through clinical chart review in a Spanish hospital from 2003 to 2011. Demographic variables, baseline cardiomyopathy, comorbidities, indication and type of ICD implanted were registered. During the follow up period we identified the presence of inappropriate shocks, its leading cause and associated costs.  Results:During the study period, a total of 227 patients were implanted with an ICD, mean age 63.2 years (26-82). Eighty-six percent were men, 64.6% with ischemic cardiomyopathy, 78.4% with heart failure, 70.4% with EF < 35% and 13.1% with AF. Almost 40% with a primary indication. The proportion of single, dual and CRT-D was 54.6%, 20.3% and 25.1% respectively. After a median follow up of 4.46 years, 27 patients had had 42 inappropriate episodes. Average time since implant to first inappropriate shocks was 1.3 years (range 0.02 to 3.84 years). Patients suffering from inappropriate shocks had higher mortality (33.3% vs 13.7%; p <0.05). Almost 67% of the episodes were due to supraventricular tachycardia, 12% to noise detection, 19% to Wave T overdetection and 2.3% due to other causes. Sixty-three percent of episodes required an emergency visit and 39% a non-scheduled visit to the cardiologist. Seven episodes (16.7%) required hospitalization (4 for electrical noise and 3 for overdetection), six of whom required a surgical intervention. Average length of stay was 5.1 days. Finally, overall mean hospital cost was €2,813 per episode.  Conclusions: The great majority of the episodes was due to supraventricular arrhythmias and finally resolved without hospitalization. The mean hospital cost per episode was €2,813. Hereby, the reduction of inappropriate shocks has an important impact from a clinical and economic perspective.