OBJECTIVES: Recent data suggest that fungal foot infections along with other risk factors are predisposing conditions for bacterial cellulitis and erysipelas of the leg (BCERL). However, there is limited information available on the number of cases of bacterial cellulitis and erysipelas of the leg and related treatment costs. The purpose of this study was to assess the burden of illness of BCERL in The Netherlands in 2001. METHODS: Data for this study were obtained from different linked databases: hospital information was obtained from the Dutch Medical Registry for ICD-9-CM codes 628.6 (bacterial cellulitis) and 035 (erysipelas), including all Dutch citizens. Those patients not admitted to the hospital were estimated using general practitioner data (65.000 residents). These data were extrapolated using age/gender and disease specific standardisation. The same sample was used to assess the localisation of the infection. For all resources reimbursement costs were available. RESULTS: In 2001, approximately 30,000 patients (195 per 100.000 inhabitants) have suffered from BCERL. Twenty-five hundred patients of these patients were admitted to the hospital with an average length of hospital stay of 12.1 days. The average costs per hospitalisation for BCERL were $6700; total costs for the Netherlands were $17.1 million. Consultation costs were the second most important contribution to the total costs; $3.5 million. The contribution of prescription drugs to the total costs was limited; 0.1 million€ for the hospitalised patients and $0.9 million for the outpatients. CONCLUSIONS: BCERL infections are common and serious infections in The Netherlands. Hospitalisation only occurs in less than 10% of the patients but contributes more than 80% to the total costs that cumulate up to $21 million a year. Fungal foot infections along with other risk factors have been identified as predisposing conditions for BCERL. Screening and treatment of patients presenting such risk factors may help reduce the economic burden of BCERL.