In this paper we estimate the economic burden of respiratory illness in rural Uttar Pradesh (UP), a state in North India. This is based on a large comprehensive survey covering sample of 7564 households (HH) (16264 individuals) in 6 districts and 51 villages in UP. The survey, collected data on costs incurred on doctors` fees, hospitalization, medicine, additional cost for special diet and days lost. The average costs incurred are higher among males by 1.2 times. The total direct health care cost for the entire adult population (greater than equal to 15 years) in the state of UP (rural) comes to 548.1 Million rupees (1 US $= Rs. 48) per month. The economic value of the days lost due to illness in one month is Rs 4233 Millions. Cleaner fuels, health education and better health care can avoid some of these expenditures.