As tourism is the mainstay of the Maldives' economy, this country recognizes the importance of controlling mosquito-borne diseases in an environmentally responsible manner. This study sought to estimate the economic costs of dengue in this Small Island Developing State of 417,492 residents. The authors reviewed relevant available documents on dengue epidemiology and conducted site visits and interviews with public health offices, health centers, referral hospitals, health insurers, and drug distribution organizations. An average of 1,543 symptomatic dengue cases was reported annually from 2011 through 2016. Intensive waste and water management on a resort island cost 1.60peroccupiedroomnight.Localvectorcontrolprogramsoninhabitedislandscost35.93 for waste collection and 7.89forhouseholdvisitsbycommunityhealthworkersperpersonperyear.Ambulatorycareforadengueepisodecost49.87 at a health center, while inpatient episodes averaged 127.74atahealthcenter,1,164.78 at a regional hospital, and 1,655.50atatertiaryreferralhospital.Overall,thecostofdengueillnessintheMaldivesin2015was2,495,747 (0.06% of gross national income, GNI, or 6.10perresident)plus1,338,141 (0.03% of GNI or 3.27perresident)fordenguesurveillance.Withtourismgeneratingannualincomeof898 and tax revenues of 119perresident,resultsofaninternationalanalysissuggestthattheriskofdenguelowersthecountry′sgrossannualincomeby110 per resident (95% confidence interval 50to160) and its annual tax receipts by 14perresident(957 to $22). Many innovative vector control efforts are affordable and could decrease future costs of dengue illness in the Maldives