Introduction: Regardless of the health system to which we refer, emergency medical services costs are very high. Correct management decisions in the emergency department (ED) are of great economic importance because of the expensive therapy and the large number of patients. The exact definition of the cost structure, as well as identification of the main factors involved in increased costs may lead to optimization of expenses. Aim: Identification of the main factors related to the rising cost of medical emergency services. Materials and methods: The study retrospectively included 1255 patients presented at the hospital ED. In our study cardiovascular emergencies represented the most frequently encountered disorders. We have identified the following conditions of exacerbation: the lack of adherence to treatment, inadequate nutrition, respiratory tract infections, alcohol consumption, smoking, exposure to extreme temperatures, exercise. A special concern is represented by the overuse of the ED for nonemergency and noninsured persons visits. Conclusions: Improving the health activity in the field of primary care, diversification of health education methods, the introduction of compulsory preventive controls and implementation of diagnostic and treatment protocols represent strategies for cost reduction.