OBJECTIVES: Estimate the direct medical cost related to diabetes-patient hospitalization suffering severe hypoglycemia from the Instituto Mexicano del Seguro Social (IMSS) perspective. METHODS: A retrospective analysis was performed in order to estimate the annual costs due to DM patients suffering SH and requiring hospital care at the IMSS between January 1st and December 31st, 2014. The unitary costs reported in public tabulators (IMSS 2015) were considered. RESULTS: During 2014 the IMSS reported close to 71,800 hospitalized diabetes patients.  Among these, around 3,500 are hypoglycemia related.  Besides this, with the diagnostic “Other types of hypoglycemia” (CIE-10: E16), there were 3,600 cases, among which 53% are of patients aged 60 to 79 years old.  We estimate a per cápita average cost, for inpatients with SH, of MNX$83,447.78 per year; 95% of the total costs are due to the hospitalization and ER, with average costs of de MNX$66,348.40 & MNX$12,218.50, respectively. CONCLUSIONS: The risk of a SH case increases as the patient requires higher insulin dosage. It was observed that the hypoglycemic events may result in severe economic complications.  The findings of the present study coincide with international studies, where the higher costs belong to hospitalization and ER.  This further stresses the importance of considering better treatment strategies for diabetic patients which allow for proper care without economically debasing healthcare institutions.