This study presents an integrated methodology for evaluating operations and maintenance (O&M) costs for floating offshore wind turbines (FOWTs), incorporating vessel motion dynamics. By combining UWiSE, a discrete-event simulation tool, with SafeTrans, a voyage simulation software, vessel motion effects during offshore operations are modeled. The approach is demonstrated in a case study at two wind farm sites, Marram Wind and Celtic Sea C. Three major component replacement (MCR) strategies were assessed: Tow-to-Port (T2P), Floating-to-Floating (FTF), and Self-Hoisting Crane (SHC). The T2P strategy yielded the highest O&M costs—94 kEUR/MW/year at Marram Wind and 97 kEUR/MW/year at Celtic Sea C—due to the extended MCR durations (90–180 days), leading to lower availability (90–94%). In contrast, the FTF and SHC strategies offered significantly lower costs and downtime. The SHC strategy was most cost-effective, reducing costs by up to 64% while achieving 97–98% availability. The integrated approach was found to be either more restrictive or more permissive depending on the specific sea states influencing the motion responses. This variability highlights the critical role of motion-based dynamics in promoting safe and efficient O&M practices, particularly for advancing FOWT operations.