Objectives: The aim of this study was to examine the costs of tinnitus in The Netherlands from a health care and a societal perspective. Furthermore, the impact of disease characteristics and demographic characteristics on these costs were examined. Methods: A bottom-up cost of illness study was performed, using the baseline data on a cost questionnaire of a randomized controlled trial investigating the (cost) effectiveness of an integral multidisciplinary treatment for tinnitus versus care as usual. Mean yearly costs were multiplied by the prevalence figure of tinnitus for the adult general population to estimate the total cost of illness of tinnitus to society. Because cost data usually are not normally distributed, a nonparametric bootstrap resampling procedure with 1000 simulations was performed to determine statistical uncertainty of the cost estimates per category. Several questionnaires measuring disease and demographic characteristics were administered. The impact of disease characteristics and demographics on costs was investigated using a multivariate regression analysis. Results: Total mean societal cost of illness was Euro6.8 billion (95% confidence interval: Euro3.9 billion-Euro10.8 billion). The larger part of total cost of illness was not related to health care. Total mean health care costs were Euro1.9 billion (95% confidence interval: Euro1.4 billion-Euro2.5 billion). Significant predictors of both health care costs and societal costs were tinnitus severity, age, shorter duration of tinnitus, and more severe depression. Conclusion: The economical burden of tinnitus to society is substantial, and severity of tinnitus is an important predictor of the costs made by patients.