This report provides information on the 93 locally-acquired cases of invasive pneumococcal disease (IPD) notified in children and adults in north Queensland in 2001. Indigenous people represented 38 (41%) cases. Almost half (45) of all cases were in children under 15 years of age, 20 (44%) of these were in children less than 2 years of age and 20 (44%) in Indigenous children. Five severe cases of IPD occurred, all in non-Indigenous children under 2 years of age. Nine (10%) of the isolates from cases, mainly in young children, had some level of resistance to penicillin. Pneumococcal vaccination programs (including the Indigenous 'elderly and at-risk' adult program and the paediatric 'Indigenous and medically at-risk' conjugate vaccine program) are in place in Queensland although the vaccine is not currently funded for other at-risk groups. If vaccine recommendations had been adhered to in a timely fashion, two of the cases in children and one third (16) of the cases in adults that occurred in 2001 could potentially have been prevented. Commun Dis Intell 2002;26:520-524.