Many people in Ireland suffer from chronic diseases including AF, diabetes, COPD and asthma. With the prevalence of these conditions expected to rise, general wellbeing and quality-of-life will be increasingly affected. Chronic conditions also account for most of the healthcare resources used, and represent a significant economic burden for Ireland in the future. OBJECTIVES: Estimate the number of preventable disease associated events and costs associated with poor management of patients with AF, diabetes, COPD and asthma. METHODS: For each province, calculate the number of patients diagnosed with AF, diabetes, COPD or asthma, based on disease prevalence and 2011 Census data. Estimate the number of patients not achieving target management of their condition and the associated number of preventable events and total costs, using publically available information. RESULTS: Of the approximately 59,647 patients diagnosed with AF in Ireland, 23,561 patients are not receiving appropriate anticoagulation treatment. This results in 531 patients experiencing an avoidable stroke each year, costing the healthcare system around €9.3m. Amongst the 238,589 patients diagnosed with type 2 diabetes, 77% will not achieve a target HbA1c of 6.5% or less, resulting in an expense of €886m and 12,493 avoidable deaths each year. In addition, 30% of diagnosed COPD patients, and as many as 60% of asthma patients, are not managing their condition effectively, costing the Irish healthcare system €899m per year in hospital admission costs alone. CONCLUSIONS: Much of the chronic disease burden is caused by preventable risk factors. This is intended as a key policy lever, to elevate chronic diseases on the health agenda of key policymakers, providing them with better evidence about risk factor control, and persuading them of the need for health systems change. Unless steps are taken now to effectively deal with chronic diseases, Ireland is headed for serious financial and quality-of-life crises.