Trachoma is a disease process that progresses through multiple stages before reaching a disabling stage (trichiasis) and causing its maximal disability (blindness). At present, the disease affects primarily poor populations in poor countries. The burden can be described either by the financial burden of lost potential productivity among individuals who are disabled as a result of the condition, by the disability adjusted life years associated with the condition, or the resources necessary to limit the other burdens. Comparisons of the resources necessary to limit the other measures of burden with the amount of burden eliminated are cost-benefit analyses or cost-effectiveness analyses. A coordinated strategy to control the burden exists; the strategy involves surgery, antibiotics, face washing, and environmental change and education. The results of the best cost-effectiveness analyses that have been done comparing the individual components of the strategy suggest that, from a societal perspective, the most cost-effective way of limiting the disability adjusted life years or lost productivity burden associated with trachoma is to treat the later stages through surgery rather than the earlier stages through antibiotics. As areas that are affected at present continue to develop economically, the general improvements in hygiene that accompany these changes are likely to result in decreased infection and transmission.