OBJECTIVES to evaluate the economic burden of dengue from public payer and societal perspectives in Brazil. METHODS investigation was designed as a multicenter cost study. Suspected dengue cases were recruited during 2012/2013 in four endemic regions (city): Midwest (Goiania), Southeast (Belo Horizonte and Rio de Janeiro), Northeast (Teresina and Recife), North (Belem). Participants were suspected or laboratory confirmed dengue cases, treated in ambulatory or hospital settings (private and public sectors). A household interview was scheduled 20-30 days after the onset of clinical symptoms. The time horizon was one-year considering dengue seasonality. We calculated the direct cost, public payer perspective and direct/indirect costs for societal perspective. Estimation of annual national dengue costs took into account cases reported by notification system (SINAN) having possible under-reporting from passive surveillance. RESULTS we screened 2,223 patients and 2,097 (94.3%) symptomatic dengue cases were included. The majority of patients were adults. 1,661 cases were treated in ambulatory and 436 cases in hospitals. In the ambulatory cohort, the average number of medical visits ranged from 1.2 to 4.2. A higher number of medical visits were recorded among inpatients (3.2 to 5.0). For the public payer perspective, estimated cost per case was USD 43 (95% CI: 39-47) ambulatory and USD 237 (95% CI: 202-248) hospital. Dengue illness in Brazil was estimated to cost USD 126 million (95% CI: 112-135), ambulatory and hospitalized cases considering the reported cases (SINAN). Outpatients cost account for 62% of the total costs. For the societal perspective, the estimated cost per ambulatory case was USD 163 (95% CI: 142-169) and USD 465 (95% CI: 407-591) hospital. Dengue illness was estimated to cost USD 389 million (95% CI: 339-425), ambulatory and hospitalized cases. CONCLUSIONS our results show evidence of substantial economic impact in Brazil. We have provided a timely economic evaluation of dengue.