OBJECTIVES: Autism is a developmental disorder associated with high unmet needs and significant costs to patients and society. The objective of this study was to assess the socioeconomic impact of autism in children and their families in Attica region in Greece.  METHODS: A questionnaire was developed based on the international literature and was validated by Greek experts. It was administered to the parents of all children attending special schools, day care units and centers for special treatments in Attica, which accounts for approx. 50% of the Greek population. Data on direct medical costs (including hospital services, drugs, health professionals and alternative medical treatments), non-medical costs (including special education services and out of pocket expenditures) and indirect costs (including parental lost productivity and social benefits) were collected and analysis was processed in SPSS 7.1 RESULTS: Of the 191 questionnaires administered, 70 were completed and returned (response rate 37%), and included in the analysis. The total mean annual cost per autistic child living with parents was estimated at €9,630. Direct medical, non-medical and indirect costs accounted for 11% (€1,037), 45% (€4,311), and 44% (€4,282), respectively. Key cost drivers were the social benefits, out-of-pocket non-medical expenses, special education services and parental productivity losses. 47% of the mean annual cost is incurred by families, while 53% (including disability allowances and health care services) is covered by the state budget.  CONCLUSIONS: To the best of our knowledge, this is the first study estimating the costs associated with autism in Greece. The annual cost of supporting an autistic child is large and approx. half of it falls on the family. Policy makers should focus on lightening the families’ economic burden for managing the disorder, especially in an era of severe economic crisis and austerity.