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Background: Despite advances in endoscopic and pharmacological treatment of peptic ulcers, complications of this disease are not uncommon. Perforation, bleeding, and obstruction continue to be seen in spite of multiple and mostly successful strategies to prevent and treat peptic ulcers. With our country debating healthcare reforms and facing serious problems with providing less expensive quality care, cost of treatment to improve its outcomes needs to be studied.Objective: The purpose of this study was to determine nationwide trends in hospitalization, mortality and hospital charges for patients with complicated peptic ulcers.Methods: The Nationwide Inpatient Sample for Healthcare Cost and Utilization Project (HCUP) was analyzed for the trend of peptic ulcer complications in reported hospitals. DRG code (176 ) encompassing all peptic ulcer complications was used for data extraction. Number of discharges, hospital charges and mortality was researched for a period of 15 years from 1993 to 2007. Prevalence of peptic ulcer complications in discharged patients was calculated per 100,000 hospitalizations. All analyses were performed on data that were weighted to provide national estimate. Significance testing was done by Z-score. R-squared values were used to express trends. Results: Examined data revealed that number of patients hospitalized for complicated peptic ulcer ranged from 26,533+742 in 1993 to 28,706+824 in 2007, peaking at 31,522+900 at 1997. Charges however for treatment of these patients increased 268% from $9,235+198 in 1993 to $24,798+659 in 2007 (p<0.001, R2=0.964). The calculated charges for these patients treated in reported hospitals increased from $245 millions in 1993 to almost $712 millions in 2007 - close to a 3-fold increase. Prevalence of complicated peptic ulcer diagnoses ranged from 77.3 to 72.6 per 100,000 hospitalized patients, peaking at 90.9 in 1997 (R2=0.366). Mortality decreased significantly from 3.39% in 1993 to 1.58% in 2007 (p< 0.001, R2=0.6994). Conclusion: The decline in mortality among patients with complicated peptic ulcer was achieved by significant increase in hospital costs of their treatment. If all other aspects of treatment costs and utilization of resources are excluded, one can speculate that approximately 1million dollars was spent to save one live of a patient with complicated peptic ulcer in 2007 vs. 1993. Results of this study demonstrated that mortality, the most important outcome of managements of patients with complicated peptic ulcer disease has improved significantly over 15 year period. It was achieved by a tremendous increase in costs.