The aim of this study was to estimate the burden of infectious intestinal disease (IID) and cost of illness at the community level from a societal aspect. A retrospective, age-stratified cross-sectional telephone study was carried out in Malta in 2004–2005. The number of cases, resources used and cost of resources were computed. The resources involved direct costs (health-care services, stool culture tests, medicines and personal costs) and indirect costs (costs from lost employment by cases and caregivers). This study estimated 0·421 (95% CI 0·092–0·771) separate episodes of IID per person per year in Malta which corresponds to 164 471 (95% CI 35 941–301 205) episodes of IID per year or 450 (95% CI 98–825) episodes of IID each day. The largest proportion of cost is due to provision of health-care services with €10 454 901 [Maltese liri (Lm) 4 558 970] per year; followed by €963 295 (Lm 2 209 393) in lost productivity; €1 286 286 (Lm 561 078) in medicines; €152 335 (Lm 66 452) in stool culture testing and €71 487 (Lm 31 183) in personal costs, giving a total cost of illness of over €16 million (7 million Lm) per year. The burden and cost of IID are high enough to justify efforts to control the illness. Such estimates are important to assess the cost-effectiveness of proposed specific interventions.