OBJECTIVES: Invasive meningococcal disease (IMD) is an uncommon but life-threatening disease. In France, the estimated incidence is 0.79/100000 inhabitants in 2015 but data relative on burden, sequelae and costs are scarce. This study aimed to describe hospitalized patients with confirmed IMD diagnosis, and to characterize their care pathway including for sequelae. METHODS: A retrospective SNIIR-AM cohort (a French national healthcare claim system of nearly 66 million) analysis of all IMD patients-related hospitalizations between 01-Jan-2012 and 31-Dec-2017 was based on the health care consumption and followed up until either death or study end (31-Dec-2017). This cohort has been matched 3:1 with a control group (non-IMD hospitalized patients) according to age, sex and geographical area. The sequelae were identified during or after IMD hospitalizations (ICD10 code A 39, related/associated) through device or drugs use as surrogate. RESULTS: A total of 3532 patients were hospitalized for IMD during the analyzed period (mean of 588 cases hospitalized/year); average age was 29.7 years old (YO), among them 52% were males. Two hospitalization peaks: infants under one year of age (13.3%) and adolescents between 15 and 19 YO (11%). Average duration of hospitalization: 14.8 days (Standard Deviation-SD=24 days) for all cases; 10.0 days (SD=13.7 days) for subjects < 25 YO. A significantly higher proportion of IMD in Universal-Complementary-Health-Coverage affiliated patients was observed compared to controls in all age groups except those over 60 YO. A total of 456 (12.5%) patients died, 293 (8.3%) deaths occurred during the initial hospitalization. Sequelae have been identified in 1139 (32%) of survivors, one sequela for 21.7% and at least two for 10.5%. The most common being renal impairment (11.3%), epilepsy (8.7%) and depression/anxiety (8.0%). CONCLUSIONS: These data confirm the morbi-mortality of IMD, especially in infants and emphasize the importance of their primary prevention to avoid complications /sequelae and deaths.