Vaginal estrogen is a common therapy for many gynecologic conditions. Medication cost poses a barrier to medication compliance. The purpose of our study is to report patient cost savings by utilizing compounding pharmacies in the preparation of topical vaginal estrogen.A survey of 10 topical vaginal estrogen compounding pharmacies was performed and prescription cost data was obtained. The University of Oklahoma Outpatient Pharmacy and the 2008 Wolters Kluwer Health Pharmaceutical Audit Suite were cost comparisons for compounded estrogen. All data was processed using statistical software yielding descriptive statistics.The average cost of compounded estrogen was $42.22. At the University of Oklahoma Outpatient Pharmacy, average cost for branded vaginal estrogen preparation was $137.70. The national cost average for branded vaginal estrogen preparations was $82.42. Cost savings of $94.98 (69%) locally and $40.20 (51%) nationally was identified.Compounded estrogen is a cost conscious alternative than branded preparations.