Objective To measure and compare the cost of PICCs and PORTs from catheter insertion to removal, and to provide reference for choosing vascular access device. Methods By using cross-sectional survey and retrospective cohort study, a cost analysis and a step method for project cost allocation were adopted based on propensity score matching (PSM) to calculate and compare the total cost of PICCs and PORTs from a healthcare perspective. The total cost comprised insertion, maintenance, removal and management of complications. Results A total of 1 050 patients were included in the retrospective study, of whom 504 patients were matched for total indwell time, 276 for 3 to 6 months indwell, 106 for 6 to 9 months indwell, and 35 for 9 to 12 months indwell. In each subgroup of indwell time, the total cost, insertion cost and removal cost of PICCs were significantly lower compared with PORTs (P<0.01 for all), while the costs for management of complications were significantly higher for PICCs than those for PORTs (P<0.05 for all). The maintenance cost for PICCs was significantly higher than the cost of PORTs during the total dwell time (P<0.01), while that had no significant differene in the other subgroups (P>0.05 for all). Conclusion The total cost is lower in patients receiving a PICC than those with a PORT when the catheter indwell time was shorter than 12 months. From the perspective of the healthcare input, PICCs are recommended as the more economic central venous access devices for medium-to long-term use.