OBJECTIVES::  The objective of this study was to assess the effectiveness and costs of breech version with acupuncture-type interventions, including moxibustion, compared to expectant management for women with a fetal breech presentation at 33 weeks gestation. METHODS:: A decision tree was developed based on data extracted from the Brazilian Public Health System database (DATASUS). Efficacy and transition state assumptions came from a systematic review performed. The model accounted for cephalic versions, number of caesarean procedures and costs. The relative effectiveness of moxibustion associated with acupuncture procedure was based on a specific meta-analysis. A probabilistic sensitivity analysis was conducted to evaluate the robustness of the results. Main outcome measures: calculated percentages of breech presentations at term, caesarean sections and costs from the Brazilian Public Health Care system (SUS) perspective. RESULTS::  The total number of labor procedures previously identified in DATASUS was 1.9 MM. From these, we calculated a total of 77.885 women with breech presentation fetus at 33 weeks. Considering the moxibustion associated with acupuncture procedure efficacy (54%) applied, the total number of caesarean procedures decreased from 23.560 in control arm to 21.572 in the experimental arm. The total calculated costs for the experimental arm were: R$ 2.7MM (moxibustion), R$ 51.6 MM (caesarean) and R$ 27.2 MM (regular labor), totaling R$ 81.7 MM, versus R$ 80.6 MM in the control arm. The calculated ICER was very low (R$ 88,50 per cephalic version). Additionally the probabilistic sensitivity analysis confirmed the results and demonstrated that the moxibustion associated with acupuncture was cost effective in 86% of simulations. CONCLUSIONS::  These data suggests that offering moxibustion associated with acupuncture to women with a breech fetus at 33 weeks gestation reduces the number of breech presentations at term, thus reducing the number of caesarean sections needed and is a cost-effective approach.