Background: Little information is publicly available to determine the economic impact hemorrhagic fevers with no available or stockpiled medical countermeasure (MCM) have on health care systems. This study examined the direct and indirect health costs of imported cases of the hemorrhagic fevers Crimean Congo (CCHF), Hanta, Lassa, Marburg, Nipah and Rift Valley (RVF) in the European Union, United Kingdom and United States. Methods: An adapted direct cost model using sourced conservative treatment regimens for the respective fevers were costed. Reported reproduction ratios, fatality ratios and case reports were used to determine the spread of infection, front-line mortality, and the cost of and extent of an imported outbreak. The average length of hospitalization and death rate was factored into the care costs including front-line casualties and cost of replacement. Native community replication was represented were transmission allowed. Costs were converted into American, British, and European healthcare costs. Results: Interhuman infection applied to the replication number of the imported case increased the direct and indirect costs for Lassa and Marburg cases. CCHF, Hanta and RVF cases remained local vector dependent with Nipah costs confined largely to direct case zero cost (R0<0.6). Average hospital stays as published in case reports ranged from 4.4 days (CCHF) to 28 days (Rift Valley Fever). Direct costs ranged from $77,865 (CCHF) to $787,266 (Marburg) per first imported case with <1.6-fold increase for Marburg and <1.8 increase for Lassa in direct and indirect costs through reproduction. Conclusions: Significant direct healthcare costs were calculated for six imported hemorrhagic fevers with Lassa and Marburg having potential to increase costs beyond case zero through local transmission. The costs highlight the potential savings that effective local MCM availability could have in reducing the cost impact of hemorrhagic fever importation.