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Objective: Hyperbaric oxygen therapy is covered by the NHS under Specialist Services Definition Set 28. The indications and availability of the therapy have been influenced by educational failures, perceived costs and, compared with drug studies, the small number of controlled trials. This study aimed to inform this debate by calculating the direct costs to the health service of hyperbaric oxygen therapy for inpatients using a single, one-person chamber., Method: The costs included in this cost analysis were: hyperbaric chambers, staff, oxygen, property and cleaning, miscellaneous and general overheads. All costs are for 2004., Results: Lower and upper costs were calculated. Start-up costs range from pounds 64,800 to pounds 110,000 depending on the hardware selected. Annual costs, including 10-year amortisation of capital costs, range from pounds 40,069 to pounds 57,618 and per-treatment costs range from pounds 30 to pounds 41. Oxygen recirculation becomes cost effective after four to six years., Conclusion: Hyperbaric oxygen therapy is an inexpensive treatment that should be routinely available for conditions where evidence indicates that tissue hypoxia is a significant component of the injury or disease.