The diagnosis of cancer in Nigeria is perceived as a hopeless situation and is not unusual to expect total mortality of all sufferers. Choriocarcinoma is particularly important because it is nearly completely curable. The aim of this study was to review the socio-demographic characteristics, cost implications and management of choriocarcinoma in a tertiary institution in North-west Nigeria. This was a 5-year retrospective study. Records of the patients diagnosed with choriocarcinoma from 1st January, 2008 to 31st December, 2012 were retrieved and relevant data extracted and analyzed using the SPSS for windows version 20.0. There were 24 cases of choriocarcinoma giving an incidence of 1.5 per 1000 deliveries. The mean age of the patients was 33.21 ± 2.14 years. Recurrent vaginal bleeding (95.2%) was the most common form of presentation. The common predisposing factors were complete mole (47.6%) and abortion (28.6%) while the metastatic sites were the vagina/pelvic structures (42.9%) and lungs (33.3%). Many, (33.3%) signed against medical advice (SAMA) while 61.9% had methotrexate or MAC as first-line treatment. The common complications were disease progression despite treatment (33.3%) and myelosuppression (33.3%). The average cost of treatment was ₦200,000 ($600). The 5-year survival rate was 9.5%. The incidence of choriocarcinoma in this review was low. The cost of treatment was out of reach of most patients hence the need for health insurance coverage of all Nigerians. The use of methotrexate and MAC regimen as first-line chemotherapy appeared to be ineffective as the disease progressed despite treatment. The five-year survival was dismal