This paper uses a burden of illness methodology to achieve a better understanding of the cost of falls and fractures within Ireland. The base number of older people falling annually in Ireland is 130,000. About 80% of these are non-injurious with the remainder following a healthcare trajectory that may involve hospital care, GP visits, outpatient visits, informal care, long-stay care and sometimes death. Unit costs are applied to the different levels of care and aggregated to generate the overall cost of illness of falls and fractures in the country. The estimated baseline cost of falls and fractures is Euro 404 million. The largest components of this cost are: mortality, lost quality of life, long-stay care costs and hospital inpatient costs. The findings are relevant in the context of the development of a National Strategy for the prevention of falls and fractures in Ireland. Investment in such a Strategy will likely yield significant benefits.