OBJECTIVES Urinary tract infections (UTIs) are the second most common bacterial infection in primary care and are often treated empirically with antibiotics. However, outside of the United States, there has been a lack of systematic cost-of-illness studies to assess the economic cost of UTIs in the community. The objective of this study was to estimate the economic cost of UTIs in Ireland from the perspective of the health service. METHODS We conducted a secondary analysis of a dataset which contained information on adult patients (excluding pregnant women) presenting to their General Practitioner (GP) with a suspected UTI. Data was collected from 22 GP practices in the West of Ireland over a 9 month period from September 2009 to May 2010. Results from microbiological analysis to determine a positive urine culture were obtained from the University Hospital Galway laboratory. Healthcare costs were estimated on the basis of GP consultation costs, antibiotic costs, laboratory costs and secondary inpatient and outpatient costs. The latter was acquired from national clinical data on discharges in acute hospitals. RESULTS Of the 2,850 GP consultations, almost 70% of the urine samples showed no laboratory evidence of a UTI. 57% of the patients were prescribed an antibiotic and 11% of patients re-consulted within one month. Total primary care costs (including antibiotics) to treat suspected UTIs across the 22 practices was approximately €343,000 annually. Extrapolating results to a national level, the annual estimated primary care costs are approximately €19.2 million. The annual cost of UTIs in secondary care is low at approximately €155,000. CONCLUSIONS Suspected UTIs are a common reason to attend primary care services in Ireland. From the health service perspective, the overall economic cost of UTIs is mainly driven by primary care costs with comparatively low secondary care costs.