This study estimates the incidence and direct medical costs of fatal and non-fatal fall injuries among US adults aged 65 years and older in 2000. The data sources include the National Vital Statistics System, the National Electronic Injury Surveillance System-All Injury Program, the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample, and the Medical Expenditure Panel Survey. The results show that there were nearly 10,300 fatal and 2.6 million non-fatal fall-related injuries in 2000, with total direct medical costs of $0.2 billion for fatalities and $19 billion for non-fatal injuries. Fractures accounted for 35% of non-fatal injuries but 61% of the costs. Women, who made up 58% of the older adult population, incurred 2-3 times higher medical expenditures than men across all treatment settings. The study highlights the substantial economic burden of fall-related injuries and emphasizes the need for effective intervention strategies to reduce their incidence and healthcare costs.This study estimates the incidence and direct medical costs of fatal and non-fatal fall injuries among US adults aged 65 years and older in 2000. The data sources include the National Vital Statistics System, the National Electronic Injury Surveillance System-All Injury Program, the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample, and the Medical Expenditure Panel Survey. The results show that there were nearly 10,300 fatal and 2.6 million non-fatal fall-related injuries in 2000, with total direct medical costs of $0.2 billion for fatalities and $19 billion for non-fatal injuries. Fractures accounted for 35% of non-fatal injuries but 61% of the costs. Women, who made up 58% of the older adult population, incurred 2-3 times higher medical expenditures than men across all treatment settings. The study highlights the substantial economic burden of fall-related injuries and emphasizes the need for effective intervention strategies to reduce their incidence and healthcare costs.