OBJECTIVES: To determine the costs, effects, and cost-effectiveness of the treatment of Traumatic Brain Injury (TBI) with calcium channel blockers vs. standard care. METHODS: A Monte Carlo model of acute TBI was constructed from the payer's perspective and used to compare the costs and effects of treatment with calcium channel blockers to standard care. The intervention modeled was the calcium channel blocker Nimodipine intravenously, 1 mg/hr the for first 2 hours and 2 mg/hr thereafter for up to 7 days to control intracranial pressure (ICP). Standard care is no drug intervention to control ICP. The outcomes of the model were good recovery, severe disability or persistent vegetative state (PVS), and death. Outcome probabilities were derived from the literature. Average treatment costs of TBI were derived from the literature. Modeling and sensitivity analysis were performed using Data 4.0. The incremental cost, incremental effectiveness, and incremental cost-effectiveness were tested using SPSS 11. RESULTS: The incremental cost of treating TBI with a calcium channel blocker was $15,469 above standard care (p <0.001). The incremental effectiveness of treating TBI was 0.02 Quality Adjusted Life Years (QALY) more than standard care (p <0.001). The incremental cost-effectiveness of treating TBI was $24,030 per QALY (p <0.001). CONCLUSIONS: The incremental cost of treating TBI with a calcium channel blocker of $15,469 is significant, but it is not unreasonable. Considering the severity of the TBI and the importance that even a small reduction in mortality and disability would have, the incremental cost of treating TBI with a calcium channel blocker should not be considered an obstacle to treatment.