OBJECTIVES: Streptococcus pneumoniae (SP) pneumonia represents substantial morbidity and mortality worldwide. A retrospective study was conducted to describe the incidence, serotype distribution, and in-hospital mortality associated with reportable invasive SP pneumonia in all age groups in Norway from 2007–2009. METHODS: Patients with laboratory-confirmed invasive SP pneumonia were identified from the Norwegian Surveillance System for Communicable Diseases (MSIS) database from January 2007–December 2009. Population data were obtained from Statistics Norway. Incidence was reported annually as new cases per 100,000 persons. RESULTS: From 2007–2009, incidence of reportable invasive SP pneumonia decreased linearly from 11.7/100,000 to 7.1/100,000. Incidence increased with age; adults aged ≥65 years consistently had the highest incidence (2007: 39.4/100,000; 2009: 24.4/100,000), with the lowest rates observed in adults aged 20–49 years (2009: 3.35/100,000). In-hospital mortality rates were ~6% throughout the study, with the highest rates in adults aged ≥65 years (2009: 8.8%). SP was the most common pathogen reported (1,358/1,544 [88%] isolates). The proportion of 7-valent pneumococcal conjugate vaccine (PCV7) serotypes decreased from 46.7% to 20.1%, while the number and proportion of non-PCV7, 13-valent pneumococcal conjugate vaccine (PCV13) serotype disease increased, led by 19A (n=7 [1.3%] to n=23 [6.9%]). The most frequently identified serotypes in 2009 were 7F (16.8%), 1 (11.4%), 22F (11.4%), 4 (8.4%), 19A (6.9%), and 3 (6.6%). In children aged 0–4 years, 8, 1, and 0 cases of PCV7 invasive SP pneumonia occurred in 2007, 2008, and 2009, respectively. PCV13 serotypes caused 64.9% of invasive SP pneumonia in 2009, the majority in adults aged ≥60 years. CONCLUSIONS: Although incidence of reportable invasive pneumonia decreased in Norway from 2007–2009, after the pediatric PCV7 National Immunization Program was fully underway, substantial disease burden remains, particularly in older adults. Almost 65% of invasive SP pneumonia cases were caused by pneumococcal conjugate vaccine serotypes.