Purpose Incision and drainage (I&D) of abscesses is one of the most commonly performed General surgical procedures. The decision for I&D under General anaesthesia (GA) in the operating theatre is often made due to lack of equipment and staff availability in the Emergency Department (ED). The aim of this study is to compare costs for I&D under GA versus Local anaesthesia (LA) and to investigate possible cost reduction by implementation of a day surgical abscess drainage facility. Methods Data of 4730 patient presentations with abscesses over the past five years to one major teaching hospital was collected. Data and costs were analysed on patients undergoing I&D and prognostic costs for I&D in a day surgical clinic under LA were investigated. Results Over the period of one year one third of patients presenting to ED (N = 193/610) required I&D under the General surgical team. The majority of those patients by 77% underwent I&D under GA in the operating theatre. The costs for I&D in the surgical theatres increased from 2847$ to 3722$ compared to ED ranging from 310$ to 933$ per patient over the investigated 5-years. Over the timeframe of one year 75-89% of costs could be reduced by facilitating I&D under LA in ED and even more considering the material costs in a day clinical facility, respectively. Conclusion Avoiding GA in General surgical patients requiring I&D of abscesses would reduce costs. Hence, the implementation of a day clinical I&D facility would be beneficial for patients who do not necessarily need to undergo GA.