Objective: To estimate the potential impact of zinc bioforti?cation of rice and wheat on public health in India and to evaluate its cost-effectiveness compared with alternative interventions and international standards. Design: The burden of zinc de?ciency (ZnD) in India was expressed in disabilityadjusted life years (DALYs) lost. Current zinc intakes were derived from a nationally representative household food consumption survey (30-day recall) and attributed to household members based on adult equivalent weights. Using a dose – response function, projected increased zinc intakes from bioforti?ed rice and wheat were translated into potential health improvements for pessimistic and optimistic scenarios. After estimating the costs of developing and disseminating the new varieties, the costeffectiveness of zinc bioforti?cation was calculated for both scenarios and compared with alternative micronutrient interventions and international reference standards. Setting: India. Subjects: Representative household survey (n ¼ 119 554). Results: The calculated annual burden of ZnD in India is 2.8 million DALYs lost. Zinc bioforti?cation of rice and wheat may reduce this burden by 20 –51% and save 0.6– 1.4 million DALYs each year, depending on the scenario. The cost for saving one DALY amounts to $US 0.73–7.31, which is very cost-effective by standards of the World Bank and the World Health Organization, and is lower than that of most other micronutrient interventions. Conclusions: Not only may zinc bioforti?cation save lives and prevent morbidity among millions of people, it may also help accommodate the need to economise and to allocate resources more ef?ciently. Further research is needed to corroborate these ?ndings.