Nuclear accidents have the potential to lead to significant off-site effects that require actions to minimise the radiological impacts on people. Such countermeasures may include sheltering, evacuation, restrictions on the sale of locally-grown food, and long-term relocation of the population amongst others. Countries with nuclear facilities draw up emergency preparedness plans, and put in place such provisions as distributing instructions and iodine prophylaxis to the local population. Their plans are applied in simulated exercises on a regular basis. The costs associated with emergency preparedness and the safety provisions to reduce the likelihood of an accident, and/or mitigate the consequences, are justified on the basis of the health risks and accident costs averted. There is, of course, only limited actual experience to indicate the likely costs so that much of the costing of accidents is based on calculations. This paper reviews the methodologies used, in particular the approach that has been developed in the UK, to appraise the costs of a hypothetical nuclear accident. Results of analysing a hypothetical nuclear accident at a fictitious reactor site within the United Kingdom are discussed in relation to the accidents at Three Mile Island 2, Chernobyl and Fukushima Dai-ichi. (C) 2017 The Authors. Published by Elsevier B.V. on behalf of Institution of Chemical Engineers.