The aim of this work is to present a systematic review of German cost-of-illness (COI) studies of neurological diseases. COI studies serve as references for economic evaluations and provide important information to healthcare decision makers in order to allocate resources. A systematic literature review was performed to identify COI studies of neurological diseases and information was extracted by using a standardized assessment form. We found 52 studies that matched the search criteria (multiple sclerosis 6, stroke 11, migraine/headache 6, epilepsy 4, Alzheimer's disease 8, Parkinson's disease 15, dystonia 2). We were not able to retrieve any COI studies for ataxia, vertigo, ALS or CNS-tumours. Based on the literature, no valid German studies are available that would allow a detailed assessment of the economic impact of neurological diseases to society. The reviewed COI studies emphasize the difficulties to present costs, utilities and the use of resources in a transparent way. This information, however, is important to have a rational discussion about the allocation of limited resources in the healthcare systems.