Haemophilus influenzae type b invasive disease was reviewed in the Auckland paediatric population. A total of 205 episodes were confirmed by sterile cavity culture in 203 patients under 15 years of age over a seven year period. The incidence of invasive disease was 14/100,000/year in those under 15 years and 41/100,000/year in under 5 year olds. The age range was from 1 month to 11 years, with 91% under 5 years and 64% under 2 years. Most cases were due to meningitis (63%). Other diseases included epiglottitis, pneumonia, cellulitis, arthritis, and occult bacteraemia. There was only one fatality. Beta lactamase production was found in 9% of meningeal isolates. Recently a new conjugated haemophilus vaccine has been licensed in the United States for use in children 18 months and older. Consideration should be given to introducing this vaccine in New Zealand.