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OBJECTIVE: To estimate and analyse the costs for providing the expanded programme on immunization (EPI) in a rural community in the north of Viet Nam in 2005. METHODS: An ingredient approach was used to collect cost data from the perspective of the service providers. FINDINGS: The total annual cost of EPI in Bavi district was US$ 58 460 [purchasing power parity (PPP) 282 076]. Vaccines and supplies were the largest cost category (33%), followed by personnel costs (30.2%). The largest share of the total cost was due to activities at commune level (38%). The average cost per fully vaccinated child (FVC) was US$ 4.81 (PPP 23.21), much lower than the figure of US$ 15 that is generally accepted as the cost-effective threshold for EPI in developing countries. CONCLUSION: This empirical study indicates that EPI has been implemented efficiently in rural Viet Nam, but that opportunities exist to make it even more efficient.