We investigated the cost-effectiveness of strategies for screening pregnant women for herpes simplex virus (HSV) genital infection. The cost of performing tests for HSV-1 antibody and for HSV-2 antibody on each serum was likely to average approximately 10 pounds sterling per sample and the total cost of screening 37,500 pregnancies in Manchester would be between 0.4 pounds sterling and 0.5 pounds sterling million per year. This estimated cost might prevent the development of neonatal herpes due to a primary HSV infection. However, initial HSV-2 infection is also associated with neonatal herpes and therefore the above cost-estimates might be a gross underestimate.