OBJECTIVES: With increasing healthcare costs comes an increased need for economic evaluations. Standardising their methods including the use of unit costs are important to make economic evaluations a valid tool for decision-making. This review describes the status quo of economic evaluations in an Austrian context, focusing on their costing methods. METHODS: Relevant analysis of the Austrian health economic evaluations was conducted. Economic evaluations were collected via systematic review of peer-reviewed and grey literature published in English or German between 2004 and 2015. The quality of costing was assessed using criteria adopted from national and international guidelines for economic evaluations. RESULTS: A total of 93 economic evaluations were included, a relatively low number when comparing internationally. Regarding reporting, 60% of the studies did not state the study perspective, 25% did not provide the year of the costs, and 41% did not comprehensively report the applied unit costs. The costs used in different studies for the same interventions were inconsistent. When standardized information was used to derive unit costs, it mostly came from institution-based accounting, reimbursement information, tariffs, or market prices. Micro-costing was only conducted in 15 studies. Reported study funding sources pointed out the relative importance of the pharmaceutical industry compared to public financing of economic evaluations. CONCLUSIONS: This review highlights the lack of consistency in costing methods and reporting in economic evaluations in Austria. This has implications for the usability of the results to support decision-making and for between study comparisons. National guidelines should be updated to provide more specific guidance to improve the comparability and quality of future studies. A unit cost library containing generic unit costs for health and social care services should be set up in Austria, similar to those in the UK and the Netherlands.