OBJECTIVES: Disease-related malnutrition (DRM) is not confined to developing countries and remains a significant cause of diseases and deaths worldwide. Present in all healthcare settings DRM is often unrecognized and untreated. Despite information on DRM prevalence and clinical outcomes, there is comparatively little information on its economic impact. This study reviewed the assessment of DRM and associated economic burden in different geographic regions. METHODS: A comprehensive literature review was undertaken for all publications from 1998 to July 2013 using Medline, EMBASE, Cochrane, HEED databases. Search completed for English and non-English (German, Spanish, Italian, French, and Arabic) articles. Articles were systematically selected if they presented data for hospitalized patients on at least one of the following: DRM, epidemiology, costs, treatment options, clinical outcomes.   RESULTS:  Database search yielded 12,570 articles and 60 additional articles were identified via secondary hand searches. Of the 167 eligible articles; 42 provided information on DRM definition, screening and treatment guidelines, 29 on epidemiological data, 38 on clinical outcomes, and 17 on cost. Most screening tools incorporated recent weight loss, food intake, and disease severity. Prevalence estimates varied greatly within and by region; US (1%-54%), Europe (2.5%-86%), Asia (12%-55.2%), Latin America (34.8% - 78.8%), and Canada (31%-69%).  Malnourished patients compared to well-nourished patients experienced longer hospital stay (additional days between 1.6 and 6.6) and higher costs per hospital stay (19%-54.9%). Malnourished patients in the US, Europe, Asia, and Latin America incurred costs between USD$21900-$66700, EUR€4890-€12237, SGD$4606, and BRL$3807, respectively.  CONCLUSIONS: DRM assessment and prevalence varies greatly due to the disparate malnutrition definition and screening criteria. Broad estimates of the financial burden exist in some countries however the validity of some estimates is poor and lack generalizability. Health economic research is needed to address the present scarcity of data necessary to fully characterize the financial burden of DRM.