OBJECTIVE To estimate costs associated with prevention and treatment of bovine respiratory disease (BRD) in preweaned calves on US beef cow-calf operations. DESIGN Cross-sectional survey. SAMPLE 43 beef cow-calf producers whose operations had a history of BRD in preweaned calves. PROCEDURES Mail and electronic surveys were developed and administered to producers in Nebraska, North Dakota, and South Dakota to obtain information regarding costs of BRD prevention and treatment. Descriptive statistics were generated. Mixed linear regression models were used to assess factors associated with the costs of vaccines, medicine, and labor and percentage time spent on prevention and treatment of BRD in cows, replacement heifers, and preweaned calves. RESULTS 7 mail and 36 electronic surveys were completed. Median annual costs for BRD vaccines were $2.25, $4.00, and $6.25/animal, and median annual labor costs for vaccination were $4.58, $3.00, and $5.00/animal for cows, heifers, and preweaned calves, respectively. Median annual costs for medicine and labor to treat preweaned calves for BRD were $11.00 and $15.00/ affected calf, respectively. Adjusted mean annual BRD vaccine cost for preweaned calves ($7.67/animal) was significantly greater than that for cows ($3.18/animal) and heifers ($4.48/animal). CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that labor costs associated with BRD vaccination and treatment were similar to or exceeded the cost of vaccines and medicine, and most of those labor costs were associated with gathering and sorting cattle. Therefore, costs associated with labor as well as medicine and vaccines should be considered during the development of BRD prevention and treatment plans.