In a retrospective, population-based study, we estimated the age-specific incidence of invasive pneumococcal disease in Hong Kong between 1995 and 2004. The incidence rates per 100,000 were 18.3 (95% confidence interval [CI], 13.9-23.3) for children aged <or=2 years, 15.6 (95% CI, 12.8-18.6) for children aged <or=5 years and 1 (95% CI, 0.52-1.7) for children aged 6-14 years. The findings indicate a significant disease burden.