OBJECTIVES: To evaluate short-term cost-effectiveness (cost-utility) of cilostazol for the treatment of intermittent claudication from the persepective of the Scottish NHS. METHODS: A decision analytic model was constructed and analysed from the perspective of the Scottish NHS. Costs include direct medical costs including drug costs -evaluated at retail prices excluding taxes, and treatment costs. Treatment costs included the cost of primary and specialist care of intermittent claudication patients based on an independent survey of expert clinical opinion in Scotland. Short- term effectiveness was based on two published 24 week randomised clinically controlled trials of cilostazol (100mg) versus placebo. Placebo was chosen as the comparator since the majority of patients in Scotland do not currently receive intermittent claudication- specific medical treatment. Health- related quality of life was measured in the trials using the SF-36; these scores were translated into utilities using a validated mapping algorithm. QALYs were estimated over various scenarios including the base-case analysis of the most conservative assumption of immediate return to placebo utility post treatment. RESULTS: The incremental cost- utility ratio for cilostazol over placebo was estimated at approximately £12,500 per QALY. The data were not discounted due to the short time horizon of the trial. Sensitivity analysis suggested that the results were most sensitive to the cost of an angiography, the utility values estimated, and the price of cilostazol. CONCLUSIONS: Cilostazol is expected to be a cost-effective treatment for intermittent claudication patients in Scotland.