Motorcycles are the most popular means of transportation in northern Ghana, and their accidents are major causes of out-patient attendance and admissions in the Bolgatanga Municipality.This paper estimates the economic burden of motorcycle accidents in the Bolgatanga Municipality in Northern Ghana.Retrospective cross-sectional cost study.Data were collected from Drivers and Vehicle Licensing Authority, the Police, health facilities and motorcycle accident victims. Both quantitative and qualitative approaches were used for data collection. Cost analysis was based on the standard road accident cost conceptual framework.Ninety-eight percent of vehicles registered in the municipality in 2004 - 2008 were motorcycles. The motorcycles were significantly more than the cars registered. The economic burden of motorcycle accidents was estimated to be about US$1.2 million, of which, 52% were accident-related costs (i.e. property damage and administration) and 48% casualty-related costs (i.e. medical costs, out-of-pocket expenses, lost labour outputs, intangible costs and funeral expenses). Most motorcycle accident victims were in their productive ages and were males. Only a third of the motorcycles were insured. Majority of the riders (71%) did not possess valid driving license and would want to avoid the police. Main motorcycle injuries were head injuries, fractures, lacerations and contusions. Majority of the accidents were caused by lack of formal motorcycle riding training, abuse of alcohol, unrestrained animals and donkey carts.Motorcycle accidents could be reduced through law enforcement, continuous mass education and helmet use.