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Cost-benefit analysis has for a long time been used for appraisal of transport projects. However, the traditional cost-benefit analysis does not comprise all effects of a transport project concerning, for example, an investment in new road infrastructure. The COSIMA approach has been developed in order to remedy this situation so relevant but “missing” effects can be included in the analysis in a transparent and efficient way; this is made possible by combining cost-benefit analysis and multi-criteria analysis. In this paper two case examples demonstrate how the COSIMA approach can be applied to road projects and how COSIMA allows the decision-makers to make their decision on a wider and more thorough background. The methodology is general in scope and can be applied also in other areas and societal sectors.