OBJECTIVES To compare the cost and effectiveness of two emergency contraceptive methods in minors in France and to support the payer’s analysis if it is worth to deliver ulipristal acetate for free to minors. METHODS Based on a decision-analytical model, the cost-effectiveness of two emergency contraceptive methods is compared. Pregnancy rates, outcome of unintended pregnancy in minors and resource utilization are derived from literature. Resources and their costs are considered until termination or a few days after delivery. Costs are taken from a collective perspective. Sensitivity analyses are performed on the most sensitive input parameters. RESULTS Using emergency contraception is superior to no method. The cost of an unintended pregnancy in a French minor is estimated to be 1630€ (1330€ - 1803€). Almost 4 million€ (3.1-13.7million€) could have been saved by using ulipristal acetate instead of levonorgestrel in 2010. The incremental cost of avoiding an additional unintended pregnancy with ulipristal acetate as compared to levonorgestrel is estimated to be 418€. Ulipristal acetate is most cost-effective in the subgroup of intake within 24 hours, where it is more efficacious at a lower cost compared to levonorgestrel. CONCLUSIONS Ulipristal acetate is a cost-effective alternative to levonorgestrel, given that the cost of avoiding an additional pregnancy with ulipristal acetate is less than the average cost of said pregnancies. Therefore, French minors should have free access to ulipristal acetate directly in a pharmacy. Ulipristal acetate should be used rapidly after unprotected intercourse (within 24hours) to benefit from its cost-saving potential compared to levonorgestrel use.