OBJECTIVES: Coronary heart disease, stroke and diabetes mellitus are among the leading causes of death in Germany and determine increasing costs for the health care system. Obesity, hypertension and dyslipidemia are known to increase the disease-specific risk of morbidity and mortality. For assessing the cost-effectiveness of treatment regimes for patients with obesity and additional cardiometabolic risk factors adequate costing is essential. A methodological approach was developed to create a database that decision analysts can use for various treatment options (German Cardiometabolic Cost Database). METHODS: Direct medical costs were considered for different treatment options and for costs of the risk factors obesity, hypertension and dyslipidemia, of diabetes mellitus type 2 including its micro- and macrovascular complications, and of the cardiovascular events coronary heart disease, myocardial infarction and stroke. Field and desk research was done to obtain data concerning resource utilisation and was reviewed by clinical experts. Prices have been taken of official catalogues. Resource utilisation and prices have been related in a cost database that enables to provide cost data for different treatment options and for diabetes mellitus type 2, coronary heart disease, myocardial infarction and stroke. RESULTS: The German Cardiometabolic Cost Database includes information of resource utilisation, prices and costs. It is constructed in a way that supports analyses from different perspectives and for different treatment regimes. CONCLUSIONS: The developed database enables the adaptation of cost data for future projects due to innovations in treatment of cardiometabolic risk factors.