Although agriculture is one of the most hazardous industries, the costs of agricultural injuries and illnesses are not well known. This study aimed to determine the cost burden from compensated injuries and occupational diseases in Finnish agriculture using workers compensation records. The incidence rates in 1996 were 7.4/100 for injuries and 0.61/100 for occupational diseases. Men had a higher risk of injury (RR = 1.89; 95% CI: 1.81-1.97), but a lower risk of an occupational disease (RR = 0.68; 95% CI: 0.60-0.78), compared to women. The total cost burden was 75 (Euros) per person in 1983, increasing to 215 in 1999. The total insurance cost in 1996 was 23.5 million consisting of medical care (16%), per diem (lost time compensation within one year from the incident) (37%), pension (lost time compensation after one year from the incident) (23%), survivors pension (3%), impairment allowance (7%), rehabilitation (6%), and other costs (9%). The total cost was 0.7% of the national gross farm income and 2.2% of the net farm income. The mean cost of 1996 cases was 1340 for injuries and 6636 for occupational diseases. Injuries represented 92% of the claims and 71% of the total costs. Occupational diseases represented 8% of the claims and 29% of the costs. Twenty percent of the most severe claims represented 79.5% of the total insurance costs. Injuries and occupational diseases result in significant costs in agriculture. Lost time was the largest cost item. Overall, injuries were more costly than occupational diseases. This study indicates that the 20%-80% rule applies to agricultural injury and illness costs, and from the cost standpoint, it is important to focus prevention efforts on the most severe incidents.