OBJECTIVES: Ghana experienced the worst cholera outbreak in the last three decades in 2014(Davies-Teye et al., 2015).   Evidence of the economic costs of the disease on the affected households has been limited. This study aimed to determine the economic costs associated with the cholera outbreak on households in the Coastal Region. METHODS: Two districts; high (La-Dadekotopon) and low (Shai-Osudoku) incidence areas (HIA and LIA) were used for comparative costs studies. Impact of the disease on affected households assessed based on scientifically documented economic indicators. A total of 418 (282 HIA and 136 LIA) households who experienced at least one case of cholera infection were interviewed. Direct and indirect costs were estimated. The economic impact of cholera infection on households estimated using the Tobit Regression model in STATA 13.  RESULTS: The average direct cost to households in the HIA amounted to USD 106.88, almost 2 folds higher than in the LIA (USD 62.02). Total cost saving of the cholera outbreak was USD 99,201.28 in the LIA and USD 782,611.60 in the HIA; an 8 fold increase compared to that in LIA. A unit increase of individual with no income results in 0.07 increase in cholera incidence compared to 0.05 in an income earning category whiles a unit increase in age results in 0.02 increase in household incidence. Households with unmarried persons had 0.14 higher incidences than the married. CONCLUSIONS: The study showed considerable differences in costs in HIA and LIA with higher household economic impact of cholera on the lowest income category. Results underscored the need for policy makers to implement pragmatic interventions to avert recurrent outbreaks as costing saving due to reduction of cholera cases is hugely significant.