Aims To capture the economic and healthcare resource utilization (HCRU) burden in older adults due to respiratory syncytial virus (RSV) infection. Methods An electronic literature search of PubMed, Embase, the Cochrane Library, PsycINFO, and EconLit was conducted for studies of the cost and HCRU outcomes of RSV infection in adult patients, with no language or country restrictions. The search dates for the primary studies were January 1, 2002–May 18, 2022. The methodological quality of included studies was assessed using a modification of the Critical Appraisal Skills Programme (CASP) checklist for economic studies and the Drummond checklist. Results Forty-two studies were identified that reported cost or HCRU data associated with RSV infections, with geographic locations across North America, South America, Europe, Asia, and Oceania. Generally, hospitalization costs were highest in the United States (US). Driving factors of increased cost included older age, comorbidities, and length of stay. US studies found that the national direct cost burden of RSV hospitalizations was 1.3billionforalladultsand 1.5–4.0billionforadultsaged≥60years(estimatesforothercountrieswerenotidentified).StudiesestimatingincrementalcostsforRSVcasesversuscontrolsandcostspre-andpost-RSVinfectiondemonstratedhighercostsforRSVcases.Hospitalizationsaccountedforthemajorityoftotalcosts.EvidenceLimitationsandGapsThevariabilityindefinitionsofcostoutcomes,agegroups,studyseasons,andgeographiclocationswasprohibitiveofameta-analysisandcomparisonsacrossstudies.CostandHCRUdatawerelimitedpercountryoutsidetheUS,percomorbidity,andinsettingsotherthantheinpatientsetting.Onlyonestudyreportedindirectcosts,andonlytheUShadnationalcostburdendata.ConclusionDespiteseveraldatagaps,theeconomicburdenofRSVinfectionsonhealthcaresystemsandpayerswasfoundtobesubstantial,globally,underscoringtheneedforRSVpreventivestrategiesforreducingthisburden.