Falls affect approximately one-third of community-dwelling adults aged 65 years and older annually, with healthcare costs exceeding US$80 billion in the USA alone. Home-based fall detection technologies have proliferated, yet cost-effectiveness evidence remains fragmented.

To systematically identify, appraise and synthesise evidence on the cost-effectiveness of home-based fall detection and monitoring technologies for community-dwelling older adults.

This protocol is reported following Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. Searches will be conducted across MEDLINE, Embase, Cochrane Library, CINAHL, Web of Science and economic databases from database inception to the date the searches are executed. Two reviewers will independently screen studies using Covidence, extract data and assess quality using Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 and Drummond checklists. Narrative synthesis with meta-analysis where appropriate will be employed.

Ethical approval is not required as this systematic review will analyse only previously published, aggregate data and will not involve primary data collection from human participants. Findings will be disseminated through peer-reviewed open-access publication, conference presentations and accessible formats developed with patient and caregiver advocacy organisations.

The protocol is registered with PROSPERO (CRD420261433029).