OBJECTIVES: Ireland currently administers a universal BCG vaccination programme to infants. In order to assess the cost effectiveness of this programme, it is vital to have accurate cost estimates of the burden of tuberculosis (TB) illness in infants. The aim of the current study was to cost the diagnosis and treatment of an episode of the following health states; pulmonary TB, extrapulmonary TB, TB meningitis and latent TB, from the healthcare payer’s perspective. The cost of contact tracing per primary case of TB was also estimated. METHODS: Decision trees were constructed to reflect typical episodes of care in the diagnosis and treatment of each health state. Resource use and unit cost data were applied to each node in the decision tree. The probabilities of events occurring were derived from the literature and expert clinical opinion. Main costs included were inpatient medical/surgical costs, pediatrician outpatient appointments, medications, laboratory tests and x-rays. Each health state included a cost for a Directly Observed Therapy programme. Direct medical costs were calculated and the 2012 price year was used. RESULTS: The direct medical costs of diagnosing and treating a case of pulmonary TB, extrapulmonary TB, TB meningitis and latent TB were estimated to be approximately €8153, €12224, €15752 and €894 respectively. The main drivers in the costs are the length of hospital stay and the number of pediatrician visits. The cost of contact tracing per primary case of TB was estimated to be approximately €4,248, which was based on a mean number of 9.4 contacts examined per primary TB case. CONCLUSIONS: To our knowledge this is the first investigation of costs associated with paediatric TB within the context of the Irish healthcare setting and will allow for a more robust estimation of the cost effectiveness of BCG vaccination programmes, which will benefit the healthcare payer.