Abstract: Objective: To measure and document the total service cost of patients with health anxiety and to investigate the statistical association between costs and patient characteristics, levels of anxiety and other clinical characteristics.Methods: Data on services used by 444 people with high health anxiety from five types of secondary care medical outpatient clinics were collected in interview with patients by self-report for the preceding six months. Costs associated with these services were calculated and personal and clinical factors associated with these costs were explored.Results: Mean total costs over six months were £2976 per participant and ranged from £146 to £25,200. The regression model found higher costs were significantly associated with poorer social functioning and self-reported health-related quality of life. No statistical association was found between severity of health anxiety and cost, and generalised anxiety was inversely related.Conclusion: The findings suggest that a re-examination of the simple causative relationship between health anxiety and cost in the health anxious is warranted.