OBJECTIVES: Cost-Effectiveness analysis of Drug Coated Balloon (DCB) vs. Percutaneous Transluminal Balloon Angioplasty (PTA) in the treatment of Peripheral Arterial Disease in lower limbs from Public Healthcare System (SUS) in Brazil. METHODS: An analytical decision model was considered with Target Lesion Restenosis (TLR) Avoided and total cost at the end of two year period as endpoints. An Excel model was developed. Effectiveness data was taken from a pooled analysis and second revascularization procedures probabilities were taken with KOL criterion. A public Healthcare System (SUS) payer perspective was assumed. Total direct costs for reimbursement were taken from Tabnet/Datasus–2014. Because effectiveness and cost were taken as unique values at the end of the two years, discount rate was no applied. Sensitivity Univariate analysis was done for DEB vs. PTA. For the Probabilistic Sensitivity Analysis a Monte Carlo Simulation with 1000 iterations was done. RESULTS: TLR Avoided probability with DCB was 0,856 vs. 0,600 for PTA.  DCB total cost was R$4.468 vs. R$3.737 for PTA. The ICER was R$2.856. In univariate sensitivity the ICER   the total DCB cost was tested from -10% to +10%, obtaining ICER values that were from R$2.075 to R$3.637. In the Probabilistic Sensitivity analysis, it was a 24% probability for DCB to be dominant or cost-saving, and 98,3% of been under 3 GDP per Capita for Brazil. CONCLUSIONS: DCB showed a 98,3% probability of been cost-effectiveness when compared to PTA and  a 24% probability of been cost-saving.