Purpose: This study estimated out-of-pocket (OOP) expenses associated Human African Trypano-somiasis (HAT) care, in the Democratic Republic of the Congo (DRC) and explored how they influ-enced care-seeking behavior and participation in HAT control, aiming to inform effective and finan-cially accessible elimination strategies. Methods: A sequential mixed-methods study was conducted using 16 semi-structured interviews and 6 focus group discussions, followed by a structured survey of 444 recently tested participants across 6 health zones. Medical and non-medical expenditures were collected by health structure type and screening strategy (active vs. passive). Catastrophic health expenditure (CHE) was defined as OOP costs, excluding food, exceeding 10% or 25% of annual household income. Results: Payments at health facilities, transport costs and long distances delayed care-seeking, par-ticularly in passive screening (PS). Active screening (AS) was associated with minimal OOP, 93% of visits were cost-free, with a median OOP of 0.76 USD among those incurring costs. PS generated higher expenses, only 12% of PS visits were cost-free, with a median OOP of 9.08 USD among those with expenditures. Among confirmed cases, median OOP was lower through active (9.84 USD) than PS (24.23 USD). Nearly 90% of confirmed cases sold assets or borrowed money to cover expenses. CHE was uncommon under average household income(