Complicated lymphedema was defined as any hospital admission within 2 years for a diagnosis of lymphedema or related complications based on prior research. This study demonstrates a 2.3% incidence of complicated lymphedema after breast cancer surgery. Increased health care utilization for these patients resulted in hospital charge accrual of more than $180 million in 2 years or approximately $140,000 per patient. Although limitations must be taken into consideration, the significant burden of lymphedema underscored here mandates further investigation into targeted, anticipatory management strategies for BCRL Open access: No View