Objective To compare the costs of a strategy of patient controlled remifentanil versus epidural analgesia for pain relief in labour. Design We performed a multicentre randomised controlled trial in 15 hospitals in the Netherlands, The RAVEL trial. Costs were analysed from a health care perspective alongside the RAVEL trial. Population Pregnant women of intermediate to high risk beyond 32 weeks gestation who planned vaginal delivery. Methods Women were randomised before the onset of labour, to receive either patient controlled remifentanil or epidural analgesia when pain relief was requested during labour.