OBJECTIVES to analyze costs for treating patients with Non Bacteremic Pneumococcal Pneumonia (NBPP) and Bacteremic Pneumococcal Pneumonia (BPP) from the public Health perspective, showing the hospital perspective cost and the amount of SUS reimbursement and from the private health care setting perspective. METHODS A retrospective database study was performed in Hospital Sao Paulo (HSP) and Hospital Israelita Albert Einstein (HIAE), in Sao Paolo City, Brazil. The inclusion criteria including patients over 60 years old with NBPP or BPP. Data collection was performed to identify pneumonia type, hospitalization and it costs, expressed in Brazilian reais (US$1 = R$1.7955 – mean 2008 exchange rate). RESULTS A total of 185 medical records were analyzed in HSP. 6.5% was BPP and 93.5% was NBPP. Hospital perspective cost for BPP ranged from R$205.56 to R$23,995.74; with a median of R$3,366.71 and for NBPP ranged from R$74.33 to R$24,486.03; with a median of R$691.94. The SUS reimbursement perspective for BPP varied from R$319.74 to R$1,833.15, with a median of R$ 511.36 and for NBPP ranged from R$319.74 to R$3,210.15; with a median of R$346.74. In HIAE, a total of 180 medical records were analyzed. A totla of 9.4% was BPP and 90.6% was NBPP. Hospital direct cost for BPP ranged from R$4,047.78 to R$165,955.99; with a median of R$ 19,189.55 and for NBPP ranged from R$50.00 to R$345,912.54; with a median of R$ 6,468.27. CONCLUSIONS This is the first time that significant information about the Brazilian public and private setting costs of pneumonia in elderly people was evaluated. Knowledge of these costs could be a useful tool for supply policy interventions. Combined with clinical data, this patient profile could contribute to the qualitative and quantitative evaluation of disease management policy of these patients.