The cost of unsafe abortion-related ill-health and death was the subject of a technical meeting held at the Institute of Development Studies (UK) on April 2007. It was funded by the Hewlett Foundation and brought together experts on unsafe abortion and economists specialising in costing methods. The meeting reviewed recent work estimating the cost of unsafe abortion to the health sector. Participants also discussed the economic costs to health systems, individuals and households, and the links between unsafe abortion and poverty. This issue of id21 health focus highlights the findings reviewed at the meeting and points to important lessons for decision-makers.