Background: The current paper is part of the EU-funded REHABILAID Project and aims to describe the profile of cyclists sustaining severe injuries in a road traffic incident as well as the healthcare costs associated with their injury, including hospitalization costs and out-of-pocket expenditure. Methods: Seven public hospitals were involved; Greece = 5, Italy = 1 and Germany = 1. Both the intensive care units (ICU) and subintensive care units (as high-dependency areas) were involved. Participants enrolled during a 12-month period starting from April 2013 and were followed for one year from admission date. The study used widely recommended classifications for injury severity (AIS-Update 2008, MAIS). Information on the injury was retrieved upon patients’ consent, from medical records while interviews were carried out at months 1,6,12 for personal and cost-related information. Health Care Expenditure was assessed through the MUARC’s framework. Diagnosis-related groups (DRGs) were used to estimate hospitalization costs. Results: 120 subjects enrolled in the study in total and 14 were cyclists(Greece = 1, Germany = 3, Italy = 10). Most of them were men(n = 9, 64.3%), with a mean age of 55.5 years (SD16.3;min 32-max 84). As for the current incidents, the majority occurred at city roads (n = 10;71.4%), straight roads (n = 9;64.3%) and intersections (n = 3;21.4%). Many were single-vehicle (n = 4;28.6%), lateral (n = 4;28.6%) and frontlateral (n = 3;21.4%). Half of the cyclists sustained an injury of MAIS3+ severity (n = 7;50.0%). A major injury was primarily sustained at the lower extremities (n = 10;71.4%), head (n = 7;50.0%), face (5 = 35.7%) and upper extremities (n = 5;35.7%). The mean total hospitalization cost was 5815,6(min 209,00-max 20.647,00) and the mean direct costs arising from injury was 4.047,5(min 0,0-max 24.670,00). Conclusions: Individual differences need to be taken into account in future injury prevention efforts as well as in attempts to improve healthcare system’s response to road victims.