Objective: To determine the cost-effectiveness (CE) of exercise therapy (intervention group) compared to 'general practitioner (GP) care' (control group) in patients with hip osteoarthritis (OA) in primary care. Method: This cost-utility analysis was conducted with 120 GPs in the Netherlands from the societal and healthcare perspective. Data on direct medical costs, productivity costs and quality of life (QoL) was collected using standardised questionnaires which were sent to the patients at baseline and at 6, 13, 26, 39 and 52 weeks follow-up. All costs were based on Euro 2011 cost data. Results: A total of 203 patients were included. The annual direct medical costs per patient were significantly lower for the intervention group ((sic) 1233) compared to the control group ((sic) 1331). The average annual societal costs per patient were lower in the intervention group ((sic) 2634 vs (sic) 3241). Productivity costs were higher than direct medical costs. There was a very small adjusted difference in QoL of 0.006 in favour of the control group (95% CI: -0.04 to +0.02). Conclusion: Our study revealed that exercise therapy is probably cost saving, without the risk of noteworthy negative health effects. (C) 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.