Objective: RSV bronchiolitis is a leading cause of hospitalization in infants and young children. We aimed to document the economic burden and epidemiology of RSV over seven seasons in Southern Austria. Patients and Methods: All RSV-associated hospitalized (PCR-proven) children ≤5 years of age between October 01, 2015, and April 30, 2022, were collected retrospectively. Demographic and epidemiologic data, along with hospitalization costs (direct and indirect), were calculated. Results: Among 976 children hospitalized due to RSV infection, 87% were healthy term infants, and 79% were under 12 months old. Prematurity (13%) and pre-existing conditions (11%) significantly impacted older children - 59% of cases in the 2 ^nd compared to the 1 ^st year of live. RSV-related hospital costs were approximately € 2.0 millions per year (of a total of 60 millions per year). RSV accounted for 19% of hospitalizations due to acute respiratory illness (ARI) in children ≤ 5 years, 37% of all ARI <6 months, 28% of all ARI <12, and 6.3% of all-cause hospitalizations <12 months of age, respectively. Conclusions: Every 5 ^th hospitalization due to respiratory illness in children ≤5 years of age was associated with RSV, representing 7.9% of all hospitalizations and 3.3% of all paediatric hospitalization costs.