OBJECTIVES: To estimate direct medical costs of cardiovascular (CV) events in the UK:  myocardial infarction (MI), ischemic stroke (IS), heart failure (HF), transient ischemic attack (TIA), unstable angina (UA), and revascularisation. METHODS:  We used 2006-2012 Clinical Practice Research Datalink and Hospital Episode Statistics data to identify individuals with their first and, if present, repeated CV-related hospitalisations. Patients >18 years receiving lipid-modifying therapy within 180 days before the CV event were followed for 36 months, death, or loss to follow up.  Patients were classified as CV Low/Moderate Risk, CV High Risk and CV Event History. Baseline (12 months before first CV event), acute (first 6 months afterward) and long-term costs (subsequent 30 months, annualised) were estimated by applying 2014 UK costs to drugs, hospitalisations and visits.  Incremental CV event-related costs were calculated as the difference from baseline, reporting means across all cohorts and ranking cohort-specific means. RESULTS: There were 6,408 patients in CV Low/Moderate Risk, 17,685 in the CV High Risk, and 5,274 in CV Event History cohorts. Across the three cohorts, mean incremental acute CV event costs for revascularisation were £5,669 (£5,468-£5,823), MI £4,277 (£3,707-4,573), IS £3638 (£3,472-4,572), HF £2,635 (£ 2390-£3461), UA £2,229 (£2063-£2489) and TIA £1,572 (£1441-£1814). Mean incremental long-term costs were as follows: HF £1,129 (-£37-£2829), MI £959 (£515-£1385), IS £953 (£682-£1072), TIA £793 (£340-£1692), UA £373 (£319-£677), and revascularisation -£221 (-£411-£599). Costs of CV Low/Moderate Risk cohort ranked the lowest; costs of CV Event History were the highest. Hospitalisation costs were the primary drivers for both periods. CONCLUSIONS:  Revascularisation and MI are the costliest CV events. The costs are the highest in the acute phase during the first 6 months after a CV event and generally remain higher compared with pre-event period. Using real-world evidence, the economic burden of CV patients in the UK is substantial.