The World Health Organization (WHO) has recommended widespread use of the RTS,S/AS01 malaria vaccine among children residing in regions of moderate to high malaria transmission. The recommendation is informed by RTS,S evidence, including findings from the pilot rollout of the vaccine in Ghana, Kenya, and Malawi. This study estimates the incremental costs of introducing and delivering the malaria vaccine within routine immunization programs. The study, which is meant to help inform decision-making in countries, was conducted in the context of malaria vaccine pilot introduction. Based on the findings, the financial costs of introducing RTS,S are comparable with costs of introducing other new vaccines. Findings also showed that country resource requirements for malaria vaccine introduction are most influenced by vaccine price and potential donor funding for vaccine purchases and introduction support.