This study investigates how risk associated with increased levels of accruals that might be indicative of earnings management affects the pricing and production of audit services. Francis and Krishnan (1999) suggest that auditors can deal with the risk of earnings management in five ways: (1) screen out high-risk clients; (2) charge a premium to riskier clients; (3) increase audit effort; (4) negotiate adjustments to the financial statements; and/or (5) report more conservatively (e.g., by issuing a modified report). Using a unique data set, the current study investigates two of these options: charging a fee premium and increasing audit effort. Based on previous research on audit pricing and production, we construct models for audit fees, total audit effort, labor mix (extent of experienced auditor effort), and engagement profit margin including an accruals measure that could indicate earnings management. We test these models on a sample of 119 audit engagements from one Big 6 audit firm in The Netherlands. We find that signed short-term accruals are associated with a significant increase in audit fees as well as total effort, but not with experience mix or profit margin. However, we find secondary evidence that auditors utilize more supervisors, assistants and support personnel and earn smaller profits (returns) when a client has higher levels of short-term accruals. Taken together, these results suggest that auditors are responsive to high levels of short-term accruals that may be indicative of earnings management, and will increase their work effort even if they are unable to recoup all of the related costs.