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Background Drowning is the third-leading cause of unintentional injury death worldwide. There is a limited understanding of the financial and non-financial burden of drowning in Texas by population subgroups. This cross-sectional study quantified the burden of unintentional drowning in Texas by demographic subgroups and aquatic bodies.Methods Texas Health Care Information Collection data (2016–2022) were analysed to estimate direct medical costs (inpatient and outpatient costs), lifetime indirect costs (patient and caregiver productivity loss) and disability-adjusted life years (DALY) among hospitalised drowning patients in Texas. Costs and DALYs were stratified by demographic characteristics, discharge status and type of aquatic body.Results Among 2228 hospitalisations, paediatric patients, males and non-Hispanic whites accounted for most cases. Inpatient costs were highest for individuals aged 45–64 years (US$74 435±143 931), fatal cases (US$96 269±140 315) and bathtub drownings (US$100 884±177 483), compared with other age groups, non-fatal cases and drownings in other aquatic bodies. Lifetime indirect costs totalled US$266.9 million for patients and US$422.2 million for caregivers. Drownings caused a considerable number of years of full health loss (27 445 DALYs), with the highest among children (19 610 DALYs) and individuals who drowned in swimming pools (9706 DALYs).Conclusions Drowning constitutes a significant burden in Texas. Drowning countermeasures should be targeted at groups and locations most impacted by drowning.