354 elderly individuals with a fall or fall-related injury in the emergency department were randomized to either a tailored, multifactorial program including physical therapy for fall prevention, or usual care. The purpose of the current study was to evaluate cost-effectiveness of the tailored, mutlifactorial program. Difference in total health care cost was an estimated S$362-increase in the group administered the tailored, mutlifactorial program, with an associated 0.003-increase in quality-adjusted life-years (QALYs) gained. The resulting incremental cost-effectiveness ratio (ICER) of S$120,667/QALY gained was not considered cost-effective against a willingness-to-pay threshold of S$70,000. In a few demographic subgroup analyses, including among patients with fewer critical comorbidities, higher function, higher cognitive ability, and better vision, the tailored, multifactorial program was considered cost-effective.