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This study aims to increase knowledge regarding the association of sarcopenia with hospitalization costs among a wide-ranging sample of adult hospitalized patients.A prospective study was conducted among hospitalized adult patients. Sarcopenia was identified according to the European Working Group on Sarcopenia in Older People, as low muscle mass, assessed by bioelectrical impedance analysis and low muscle function evaluated by handgrip strength. Hospitalization cost was calculated for each patient based on discharge diagnosis-related group codes and determined on the basis of a relative weight value. Costs were defined as the percentage of deviation from the cost of a patient with a relative weight equal to one. Multivariable linear regression models were performed to identify the factors independently associated with hospitalization costs.A total of 656 hospitalized patients aged ≥ 18 years (24.2% sarcopenic) composed the study sample. Sarcopenia increased hospitalization costs by €1240 (95% confidence interval (CI): €596-1887) for patients aged <65 years and €721 (95% CI: €13-1429) for patients aged ≥ 65 years. Sarcopenic overweight was related to an increase in hospitalization costs of €884 (95% CI: €295-1476).Sarcopenia is independently related to hospitalization costs. This condition is estimated to increase hospitalization costs by 58.5% for patients aged <65 years and 34% for patients aged ≥65 years.