OBJECTIVES: : Ghana has documented recurrent cholera outbreaks; however the economic cost to patients and  healthcare system has been limited (Davies-Teye et al., 2015). Even though Ghana Government has free cholera treatment policy and  National Health Insurance policy covers cholera treatment, there were documented media reports of non-compliance to these during worse outbreak in 2014. This study therefore aimed to describe socio-economic characteristics of cholera patients, cost of illness to patients and Health System in urban district to inform policy. METHODS: We conducted  cross-sectional study in Osu-Klottey. Total of 684 cholera patients randomly selected were interviewed with structured questionnaires. Health facility medical, cholera logistics and accounts records were reviewed. Data abstracted included socio-economic characteristics, Health Insurance status, cost of illness to patient and Health system and managed in EPI Info 7 and Stata 13.  RESULTS: Total of 1843 cholera infections were documented. Respondent age ranged 1-84, with mean 30.1±13.8 years, 60.6% males, 88.8% had Senior High school and below education. Occupations were 35.1 percent unskilled manual, 30.6, 27.9 and 6.4 percents skilled manual, unemployed and white color works respectively. Seventy three percent of respondent lack Health insurance. Cost of illness to patient ranged 0.00 – 250.00 and median 31.50 USD.  Among the non-insured, it ranged 0.00 – 250.00 with mean 44.20± 35.30 and insured ranged 0.00- 60.90 and mean 36.10 ± 17.80 USD. The projected cost saving for district is 81,100.64 USD. The average cost of hospital utilization per admitted patient was 9.30 USD and total cost of hospital Utilization for the outbreak was 17,085.38 USD. The total cost saving to the Osu Klottey Health system was 69,052.91 USD. CONCLUSIONS: The study underscored the economic burden cholera posed to patients and the health system in low resourced settings. Government needs to engage stakeholders to reassess challenges impeding the implementation of the free cholera treatment policy.