We investigated the phenotypic and genetic diversity (by ribotyping) of Streptococcus pneumoniae isolates recovered from French children, by blood culture from meningitis-free patients (n = 244) and by cerebrospinal fluid culture from patients with meningitis (n = 154). Isolates belonging to serotypes associated with carriage and penicillin-resistant isolates were significantly more frequent in children under 2 years of age than in older children. The seven-valent pneumococcal conjugate vaccine covered 68% of strains associated with bacteremia and 61% of strains associated with meningitis in children under 2 years. Although some serotypes were recovered more frequently from children with bacteremia than from those with meningitis, no difference in the genetic backgrounds of the two groups of strains was found.