OBJECTIVES: To estimate resource utilization and economic costs of a stroke in Specialty Hospital (SH) of XXI Century National Medical Center (CMNSXXI, in Spanish). METHODS: Data from stroke-diagnosed patients who received medical assistance in SH between 2003-05 were retrospectively collected, with the following inclusion criteria: 1) assistance with <24 hours after first symptoms, 2) CAT or magnetic resonance-confirmed stroke, and 3) >45 years old. The Barthel index was used to assess clinical status. Costs were estimated from the hospital perspective using a bottom-up approach, and only direct medical costs were estimated (hospitalization, treatment, laboratory tests, specialist visit, surgery). Clinical data and resource utilization were obtained from individual clinical. The unitary costs used are those officially published by Mexican Social Security institute (IMSS). A 3% discount rate was used, and prices were adjusted as to February 2006. Results are shown either as mean-standard (SD) or median-range and multivariate analysis test were applied. Sensitivity analyses included variation of the resource use frequency assumptions, percent complicated patients and cost inputs. RESULTS: 88 patients were included, Male 63.64%, age 55.59 (18.68), Mortality were 19.32%. More resources were utilized for complicated patients compared to non-complicated in CAT (1.68 vrs 1.12, p=0.006), thorax Rx (3.19 vrs 1.44, p=0.002), angiography(0.41 vrs 0.19, p=0.04) and days of hospitalization(15 vrs 8.4, p=0.0019). Total stroke costs were MXN$103,493 ( $101,783.2),median=$66,789.15, range $20,158 - $501,685.2). 62.36% of total costs were due to hospitalization. Per-patient costs for a complicated and non-complicated stroke were $151,308 and $69,926.03, respectively (p<0.0015). Sensitivity analysis highlighted the modelxs sensitivity to the percent complicated patients and cost inputs. CONCLUSION: Strokes causes high demand of resources in the SH, complicated patients is spending more than non-complicated. Rational use of resources must be enhanced in order to decrease costs.