This study aimed to describe the real-world economic burden of metastatic cervical cancer and identify factors associated with healthcare costs in the US. This retrospective analysis included adult women diagnosed with metastatic cervical cancer between January 1, 2010, and December 31, 2018, using Truven MarketScan Commercial and Medicare Supplemental claims databases. Patients were followed from metastatic diagnosis date until death or end of enrollment or data availability. Healthcare utilization and costs were calculated per patient per year (PPPY) for all patients including those patients receiving platinum-based chemotherapy (PBC). Utilization included outpatient, inpatient, hospice, and prescription claims. Costs comprised medical and pharmacy costs, adjusted to 2018 US dollars. Multivariable regression analysis was performed to identify factors (age, region, insurance, employment status, comorbidities, PBC) associated with costs. Of 2,413 eligible patients with metastatic cervical cancer, mean age was 52 years, 40% were employed full time, 40% lived in the southern US, and 56% had preferred provider organization plans; 1,231 patients (51%) had ≥1 comorbidity, and 684 patients (28%) received PBC. The mean PPPY numbers of outpatient, inpatient, hospice, and prescription claims were 83, 12, 4, and 195, respectively. The mean PPPY healthcare cost was $148,575 for all patients, while patients receiving PBC had a mean PPPY cost of $179,827. Regression analysis identified increased healthcare costs from several independent factors, including patients who were aged 18-30 years, lived in the northeastern US, and received PBC (p<0.0001). Patients with comprehensive coverage generally had lower healthcare costs (p<0.0001). Compared with the literature reporting PPPY cost of $35,161 for patients without cancer, this analysis demonstrated that patients with metastatic cervical cancer represent a substantial economic burden, which was higher among those receiving PBC. Further studies are needed to evaluate the economic burden between patients receiving different lines of treatments.