The physical environment has the potential to affect the behaviour, function, well-being, social abilities, orientation, and care outcomes of a person living with dementia [22]. It is therefore highly worthwhile for all decision-makers, from governments and policy makers through to property developers, designers and architects to consider both the costs and the positive and negative health consequences of dementia-specific design initiatives. This chapter will provide an overview of the relevant aspects in the field of health economics, as well as methodological challenges specific to dementia and the built environment. We have included four case studies from the international literature exploring the application of economic evaluation to the built environment, and to dementia-specific design in particular. Implications for researchers and policy makers will be discussed and recommendations provided for future research.