OBJECTIVES: Bipolar disorder (BD) is a manic depressive illness that affects more than 5.7 million of the US adult population. The economic burden of BD in the US was estimated to be $45 billion in 1991. Increasing availability of novel and more expensive therapy for BD suggests a need of assessing healthcare utilization and treatment costs in current environment. The objective of this study was to estimate the healthcare utilization and total healthcare expenditures including inpatient healthcare cost, prescription drug cost, emergency room visit and outpatient cost among US adults with BD. METHODS: The Medical Expenditure Panel Survey (MEPS) data of 2008-2012 was used to identify patients with BD using International Classification of Diseases (ICD9-CM) codes. Adults aged 21 years or older were included in the analysis. Data were analyzed using STATA14 for descriptive statistics and differences using the Student t-test and Chi-square test. Regression analysis was performed to predict associations between demographic characteristics; healthcare utilization and healthcare expenditures. Expenditures were adjusted to 2016 US dollars using Consumer Price Index (CPI). RESULTS: The final sample consisted of 1729 adults with a mean age was 43.7 yrs. Majority of adults were non-Hispanic white (77%) and were female (67%). Patients had average 23 days of hospital inpatient stay, 1597 medical provider visits, 83 outpatient visits and 15 emergency room visits per year. The total annual healthcare expenditure was estimated to be $11839, which included $3238 of inpatient health care cost, $4026 of prescription drug cost, $473 of emergency room visit and $709 of outpatient cost. Gender and age was good predictor of high healthcare expenditures, prescription drug and outpatient costs (p<0.05). CONCLUSIONS: Treatment of bipolar disorder poses significant economic burden. Cost effective delivery of medical and psychiatric care is vital for patients with BD to reduce its economic burden on healthcare system and the society.