A field study aiming to estimate the costs of tropical theileriosis was carried out in an endemic region of the North of Tunisia. Three farms were monitored for two successive summer seasons. A total number of 56 calves and 12 sentinel cows were monitored. Calves were ranked into four groups: non infected animals, diseased animals with clinical tropical theileriosis, sub-clinical Theileria annulata infected animals with anaemia and sub-clinical T. annulata infected animals without anaemia. The total costs due to disease and infection were estimated to be 15,115.058 TD (Euro 9388.20). A high proportion of these costs (50.81%) is accounted for by asymptomatic infection. Sub-clinical infections with anaemia showed the highest losses in live weight, while disease cases (prevalence 42.86%) are responsible for 23.64% of the losses with death as the most important element. A cost-benefit analysis of vaccination using a Tunisian attenuated cell line vaccine was also undertaken. Considering that the vaccine would cost 5 TD (Euro 3.10), the cost-benefit ratio of vaccination is 23.7. Sensitivity analysis of the vaccination costs shows that the indifference decision point is around 118 TD (Euro 73.29).