The costs to the National Health Service arising from bacterial infections acquired in hospital have been studied in a group of orthopaedic patients. In a cohort of 345 patients, 29 became infected; they were mostly elderly women with urinary infection. These infected patients were matched with control patients from the same cohort. Those infected stayed in hospital for 41 days, compared with the control patients who stayed for 24 days, used more microbiological services and antibiotics, and were a greater burden on the primary care services when they returned home. The extra hospital resources used cost an estimated £775 per infected patient (1978 prices), of which all but two to three per cent were accounted for by the increased length of stay. © 1979 The British Society for the Study of Infection.