OBJECTIVES: Estimating the costs associated with outbreaks and the prevention of secondary cases of invasive meningococcal disease (IMD) is needed to understand the true economic burden of IMD. We aimed to review the costs associated with IMD outbreaks that occur globally. METHODS: Literature searches were conducted in MEDLINE and EMBASE using medical subject headings and key words, such as costs, outbreaks, and IMD. Studies were included if they reported the costs associated with IMD outbreaks and were written in English, French or Spanish. All costs were converted to USD 2010. RESULTS: A total of 1672 citations were screened and 323 were potentially relevant.  Nine studies fulfilled the inclusion criteria and included IMD outbreaks with cost data from the US (n=4), England, Canada, Guinea, Burkina Faso and Australia (n=1 each) between November 1992 and November 2006. Three outbreaks occurred among high school children, one among boys aged 3-6 years, another among individuals aged <18 years, and two occurred among all ages. The majority were due to serogroup C (n=7/9). The median number of infected per outbreak was 8 (range: 3-2435). The attack rate ranged from <2 per 100,000 to 187 per 100,000, the hospitalization rate from 55.6% to 100%, and the death rate from 0% to 26%. Containment strategies ranged from targeting all members of the school where the outbreak occurred to targeting all students in the community. The overall average cost per containment was $2,368,135 (USD 2010) ranging from an average of $296,821 for small containment strategies (n=3) to $3,403,792 for large containment strategies (n=6).   CONCLUSIONS: IMG outbreaks were associated with substantial costs. While numerous reports on outbreaks were identified, few reported on the containment costs. More research in this area is warranted, particularly to understand the economic value of new vaccines given that the purpose of vaccination is to prevent potential outbreaks.