OBJECTIVES: We conducted an economic evaluation with cost and outcome data from a randomized controlled trial of promotora led interventions to increase cervical cancer screening among three populations of low income Hispanic women. METHODS: Hispanic women of Mexican origin, age 21 to 65, with no previous cervical cancer, no hysterectomy, and no Pap test within the last 3 years from El Paso, Houston, TX and Yakima Valley, WA were randomly assigned to four intervention arms, control, video, flip chart, and full (combination of video and flip chart) intervention. Micro costing, including recruitment cost, from both payer and client perspectives were used to estimate intervention costs. Effectiveness measures were the prevalence of a self-reported pap test within 6 months after the intervention, analyzed under the condition of intention- to- treat.  Incremental cost effectiveness ratios (ICERs) were the incremental cost per additional women screened. Uncertainty was examined with sensitivity analyses. RESULTS: The total cost per participant, was $216 for video, $219 for flip chart, and $223 in the full intervention. The proportion of women reporting a Pap test was 0.261 in the control arm, 0.484 in the video arm, 0.515 in the flipchart arm and 0.568 in the full intervention arm.  The ICERs were $968 comparing the control arm to the movie, $94 comparing the movie to flip chart arm and $72 comparing flip chart to the full intervention arm. CONCLUSIONS: The promotora led full interventions had important and statistically significant effects on screening behavior and compare favorably with the other two strategies designed to promote cervical cancer screening in the study. The study provides economic information for health educators in designing and budgeting promotora based cancer screening promotion programs for low income Hispanic women.