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The coronavirus disease 2019 (COVID-19) pandemic in Australia resulted in significant additional infection control precautions for consumers and the health workforce. Prior to widespread vaccine availability, substantial changes were made to the operating theatre management of patients presenting for surgery with suspected or diagnosed COVID-19. This study aimed to calculate the actual costs of operating theatre care for patients with confirmed or suspected COVID-19. Data were prospectively collected for all patients presenting for surgery with confirmed or suspected COVID-19 at the Royal Brisbane and Women’s Hospital. Information collected included patient characteristics, surgical and anaesthesia details, equipment, theatre utilisation, staffing and cleaning. The associated variable costs and usual costs of care were calculated according to the Australian National Efficient Price. We compared estimated usual costs with those estimated for patients with confirmed or suspected COVID-19. Twenty-four patients with suspected COVID-19 infection underwent surgery between May 2020 and February 2021. Cost analysis revealed a mean (standard deviation (SD), range) increase in costs of providing perioperative care for COVID-19 suspect patients of A$2252 (A$2570, A$315.85–10,398); that is, a mean of 207.5% more than usual care costs. This was primarily due to the increased number of staff and time required to complete these cases with appropriate infection control.