OBJECTIVES: While it is targeted to give the best healthcare to patients in emergency room (ER), the economic consequences of the management approach should also be considered seriously. In this report, the comparison between weekdays and weekends, of the cost of management of the most common cardiovascular reasons for admission to ER is presented.  METHODS: The invoices generated for admissions within years 2009-2011, to ER with the presenting diagnoses of (1) hypertensive diseases, (2) heart failure or (3) cerebrovascular diseases were reviewed. Invoices were prepared in Turkish Liras (TL). Mid-year TL/€ conversion rates were used (2.1567, 1.9494 and 2.3435 TL/€ in 2009, 2010 and 2011, respectively). The analysis was performed form the payer’s perspective.  RESULTS: For patients with hypertensive diseases (n=18,372), average total cost of healthcare on Saturdays and Sundays was 15.92€. This figure was 9.6% and 6.9% higher than the total cost on Monday and the average total cost on weekdays, respectively. The cost of procedures on weekend was 14.69€. This was 8.4% and 4.0% higher than the cost on Monday and than the average cost on weekdays, respectively. Average cost of medications on weekend was 1.00€. This was 16.7% and 48.0% higher than the cost on Monday and than the average cost on weekdays, respectively. Total costs on weekends were also higher than on Mondays (and weekdays average) in other diseases; 46% (38%) for heart failure and 5% (3%) for cerebrovascular diseases.  CONCLUSIONS: The cost of management was higher on weekends than weekdays for cardiovascular diseases with different nature of courses. Therefore we suggest that this amount of change in cost in ER is not related with the clinical parameters. The reason for this high weekend cost might be inappropriate use of healthcare on weekends, because the support and supervision of the multidisciplinary approach are weakened on weekends.