Tardive dyskinesia (TD) may increase healthcare burden for patients with underlying psychiatric disorders. To examine treatment patterns, healthcare resource utilization, and costs for patients with TD in Germany, a retrospective claims analysis using the Institute for Applied Health Research Berlin (InGef) database was conducted for the study period 2016-2022. Adults with International Classification of Diseases, 10th Revision, German Modification code G24.0 (drug-induced dystonia, including TD) recorded ≥2 times in 2 different quarters within 1 year during the enrollment period (2017-2021) were included in the overall TD population. The first observable code G24.0 marked the TD index date. Patients without any code G24.0 in the 4 quarters prior to index quarter were included in the incident TD population. Patients with incident TD were matched (1:3) to non-TD controls using propensity score matching analysis. Among 3,236,637 patients in the InGef research database, 389 adults with TD were identified (mean [SD] age 67.2 [16.0] years, 64.0% female, 21.1% with claims for authorized treatments for TD [tetrabenazine or tiapride]). In the matched incident TD cohort (n = 145), proportions of patients with all-cause hospitalizations (62.1% vs 48.7%), emergency department visits (35.9% vs 25.1%) and neurologist outpatient visits (69.7% vs 40.5%) were significantly greater (p ≤ 0.01) than in non-TD controls (n = 435). Annual post-index mean all-cause total healthcare costs were significantly higher for the incident TD cohort compared with non-TD controls (€13,176 vs €7288; p < 0.001). Higher healthcare costs in the incident TD population were driven by increased inpatient encounters.