OBJECTIVES: The economic burden of tuberculosis (TB) in Armenia, to our knowledge, has not been assessed. The objective of our study was to estimate total yearly direct costs of TB care for adult patients in Armenia, from a societal perspective, for 2006. METHODS: We used official sources of epidemiological data to estimate the total number of prevalent cases of TB within the adult population, including those from the civil population and the Armenian penitentiary system. The average direct total costs per TB patient  were assumed to be similar to the costs reported for the Russian Federation. We base this assumption on the similar healthcare systems, TB policies and case management within these two countries. Sensitivity analyses have been conducted to define possible ranges for costs of TB care in Armenia. RESULTS: The incidence and prevalence rates of TB in Armenia in 2006 were 48.6 and 176.1 per 100.000 inhabitants, respectively. About 75.9% of all TB cases were smear-positive (BK+); overall proportion of children and adolescents was about 8.1%. Assuming that the average yearly per-patient costs of managing BK+ and smear-negative (BK-) cases were $359 and $239, respectively, an overall cost estimate for TB control in the adult population of Armenia for 2006 totals to USD 1.41 mill. (range: USD 1.34 - 1.48 mill.). CONCLUSIONS: Despite the uncertainties around current prevalence estimates and cost data per TB patient in Armenia, even the lowest possible range of the estimated overall economic burden of TB seems to be prohibitively high for a developing country such as Armenia. Insufficient financial resources available for controlling this disease may contribute to the worsening of epidemics. Further studies are warranted to assess the current epidemiological situation and costs of TB management in Armenia.