Plain language summary What is this article about?Continuous vital sign monitoring assists in identifying deteriorating patients outside intensive care. This study analyses changes in clinical outcomes and costs before and after implementation of a clinical vital sign monitoring device in postsurgical patients on a general ward in a Dutch hospital. What were the results?Results show that after implementation, patients were less likely to be admitted to the intensive care unit, had shorter length of stay and had lower hospital stay costs. Aim: To assess changes in outcomes and costs upon implementation of continuous vital sign monitoring in postsurgical patients. Materials & methods: Retrospective analysis of clinical outcomes and in-hospital costs compared with a control period. Results: During the intervention period patients were less frequently admitted to the intensive care unit (ICU) (p = 0.004), had shorter length of stay (p < 0.001) and lower costs (p < 0.001). The intervention was associated with a lower odds of ICU admission (odds ratio: 0.422; p = 0.007) and ICU related costs (odds ratio: -662.4; p = 0.083). Conclusion: Continuous vital sign monitoring may have contributed to fewer ICU admissions and lower ICU costs in postsurgical patients. Tweetable abstractA retrospective study of clinical outcomes and costs compared with a control period indicated that implementation of continuous vital sign monitoring in postsurgical patients in a general hospital in The Netherlands may have contributed to fewer intensive care unit admissions and lower intensive care unit costs.