OBJECTIVES: The purpose of this study was to calculate and analyze the costs of treatment of the Hospital-acquired pressure ulcer (HAPU) METHODS: The study was developed as a pair-wise matched (1:2) case control study. The cases were defined by patients who HAPU during the march, 2015 until march, 2106 and the controls have been defined for patients who not developed pressure ulcer at the hospital during the same period. The pairing was carried out age, primary anda secondary diagnoses and presence of the comorbidities. Sample were excluded patients who developed PU prior to hospital admission. Costs were obtained in Reais and converted to US dollars considering the exchange rate of R$ 3.189 per US dólar. RESULTS: One hundred eighteen patients with HAPU were identified and fifty four were included in the final analysis. The incremental lenght of stay (LOS) of the cases was 83 days. Analyzing the results according to the last score collected the Braden Scale, the median costs were $134,105 for patients with very high risk, $ 93,840 for high risk, $ 110,339 for moderate risk and $ 94,645 for mild risk. Concerning costs, the average cost for cases was higher than for controls. The incremental cost associated with a HAPU episode was $ 75,311 and the incremental lenght of stay (LOS) of the cases was 83 days. CONCLUSIONS: This study demonstrated the excess LOS and high costs associated the treatment the hospital-acquired pressure ulcer. This result can be avoid with the revision of the protocol for prevention of pressure ulcer by the use of evidence-based practice, adoption of new technologies and the multidisciplinar team based care (nurses, physicians, nutritionist, physiotherapist). In addition, the protocol has the potential to eradicate enormous suffering and save thousands of lives.