To promote the sustainable management of hydropower, decision makers require information about cost trade-offs between the restoration of fish passage and hydropower production. We provide a systematic overview of the construction, operational, monitoring, and power loss costs associated with upstream and downstream fish passage measures in the European context. When comparing the total costs of upstream measures across different electricity price scenarios, nature-like solutions (67–88 EUR/kW) tend to cost less than technical solutions (201–287 EUR/kW) on average. Furthermore, nature-like fish passes incur fewer power losses and provide habitat in addition to facilitating fish passage, which presents a strong argument for supporting their development. When evaluating different cost categories of fish passage measures across different electricity price scenarios, construction (45–87%) accounts for the largest share compared to operation (0–1.2%) and power losses (11–54%). However, under a high electricity price scenario, power losses exceed construction costs for technical fish passes. Finally, there tends to be limited information on operational, power loss, and monitoring costs associated with passage measures. Thus, we recommend that policy makers standardize monitoring and reporting of hydraulic, structural, and biological parameters as well as costs in a more detailed manner.