Injuries and violence are a major public health problem in the WHO European Region. Violence is a leading cause of death and with injury, is a major contributor to health care costs. Identifying the burden and costs of injuries and violence to the health care system can be a useful starting point for demonstrating the ‘size of the problem’ to policy makers and in influencing decision-making. This project aimed to estimate the costs of injuries and violence to the health care systems across the WHO European Region. The objectives were to review costing approaches used in the existing literature, identify data to enable robust estimates of the costs of injury and violence and to develop an analytical framework that can be applied uniformly across WHO European Region countries.