Managing costs efficiently in Azure requires a combination of monitoring, automation, and planning. Start with Azure Cost Management and Billing tools to analyze usage and identify waste. Implement budgets, cost alerts, and tagging to track resources by project. Consider using reserved instances or spot VMs for long-term and non-critical workloads to save significantly. Autoscaling ensures you only pay for resources you need, while storage tiering optimizes data costs. Azure Advisor provides personalized recommendations to reduce underused resources. By enforcing governance policies with Azure Policy, organizations maintain cost discipline while still achieving performance and reliability in their cloud operations.