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To estimate annual costs of a multifaceted adolescent sexual health intervention in Mwanza, Tanzania, by input (capital and recurrent), component (in-school, community activities, youth-friendly health services, condom distribution), and phase (development, startup, trial implementation, scale-up).Financial and economic providers’ costs and intervention outputs were collected to estimate annual total and unit costs (1999–2001). The incremental financial budget projects funding requirements for scale-up within an integrated model.The 3-year economic costs of trial implementation were $879,032, of which ∼70% were for the school-based component. Costs of initial development and startup were relatively substantial (∼21% of total costs); however, annual costs per school child dropped from $16 in 1999 to $10 in 2001. The incremental scale-up cost is ∼1/5 of ward trial implementation running costs.Annual costs can reduce by almost 40% as project implementation matures. When scaled up, only an additional $1.54 is needed per pupil per year to continue the intervention.