OBJECTIVES: To estimate the prevalence-based cost of illness imposed by nocturia (≥ 2 nocturnal voids per night) in Germany, Sweden and the UK in an average year. METHODS: Information obtained from a review of published literature and clinician interviews was used to construct an algorithm depicting the management of nocturia for Germany, Sweden and the UK. This enabled an estimation of (1) annual levels of healthcare resource use, (2) annual cost of healthcare resource use and (3) indirect societal cost arising from presenteeism and absenteeism attributable to nocturia in the individual countries. RESULTS: In an average year there are an estimated 12.5, 1.2 and 8.6 million patients, aged 20 years and above, suffering from nocturia in Germany, Sweden and the UK respectively. In an average year, these patients were estimated to have 13.8, 1.4 and 10.0 million visits to a family practitioner or specialist in Germany, Sweden and the UK, respectively. Additionally, there were approximately 91,000, 9,000 and 63,000 hospital admissions attributable to nocturia in Germany, Sweden and the UK respectively and a further 216,000, 19,000 and 130,000 subjects in Germany, Sweden and the UK, respectively were estimated to incur a fracture resulting from their nocturia. The direct annual cost of healthcare resource use attributable to managing nocturia was estimated to be approximately Eur 2.32 billion in Germany, SEK 5.11 billion in Sweden and GBP 1.35 billion in the UK. The indirect societal cost arising from presenteeism and absenteeism was estimated to be approximately Eur 20.76 billion in Germany, SEK 19.65 billion in Sweden and GBP 4.32 billion in the UK. CONCLUSIONS: Nocturia appears to impose a substantial socioeconomic burden in all three countries. Clinical and economic benefits could accrue from an increased awareness of the impact that nocturia imposes on both patients, health services and society as a whole.