OBJECTIVES: To assess the economic burden of the management of hypertension and diabetes in two tertiary health facilities in Bayelsa State, Niger Delta, South-south Nigeria. METHODS: It is a retrospective review of randomly selected case notes of 531 hypertensive and diabetic patients. The demographics and cost of medicines prescribed were reviewed based on the hospital prices. These patients were randomly selected from those who attended the endocrinology and cardiology clinics of the health facilities in 2011 and 2012. RESULTS: Mean patients’ age was 55.70±12.23 years.  Most (42.2%) of them were civil servants while the rest were petty business owners (26.6%), retired workers (14.9%), farmers (10.3%), or unemployed (6%). The monthly average costs of all prescribed medications per patient for initiation and maintenance of therapy were ₦3333.43±