OBJECTIVES:  To assess health care costs and productivity losses associated with hypoglycemia in type 1 and type 2 diabetic patients per person and for Austria. METHODS:  The target population comprised type 1 diabetics and type 2 diabetics treated with sulfonylurea or insulin-based therapy. A literature review was conducted to identify studies reporting on epidemiology, health care resource use and work productivity losses of hypoglycemia. This was supplemented by market data and expert opinion. RESULTS:  Direct health care costs and productivity costs arising from hypoglycaemia in Austria in 2015 amounted to approximately € 50 million per year: around € 34 in direct healthcare costs (medication costs and community care costs as well as costs incurred in the hospital sector) and € 15.6 million in costs of lost productivity induced by hypoglycemia among persons of working age. Annual health care resource costs of hypoglycaemia for a type 1 diabetic are over three times that of a type 2 diabetic (€ 186 per T1DM patient versus € 58 per T2DM patient); the difference is even greater for productivity losses (€ 213 per T1DM patient versus € 11 per T2DM patient). However, due to the far higher prevalence of type 2 diabetes, nearly three-quarters of total annual direct costs of hypoglycaemia can be apportioned to type 2 diabetes (approximately € 9 million for T1DM versus € 25 million for T2DM). Due to differences in the age distribution of diabetic patients (around 3 times as many persons are of working age in the type 1 diabetes population as in the type 2 diabetes population), total indirect costs per year are twice as high for type 1 diabetes as for type 2 diabetes (€ 10.7 million vs. € 4.9 million). CONCLUSIONS:  Hypoglycemic events constitute a significant economic burden, which may be reduced by improved diabetes management.