OBJECTIVES The aim of this exercise is to evaluate the cost-effectiveness of rotavirus vaccination when introduced amongst children as part of the National Immunization Program of Libya. METHODS We used a published simple decision tree model about rotavirus disease and the impact of vaccination. The model has been adapted to the Libyan situation for analyzing the cost-effectiveness of the vaccine among a birth cohort of 160,000 children followed over an at risk period of 5 years. The evaluation of diarrhea events in 3 public hospitals helped to estimate the burden of rotavirus patients confirmed with lab testing during the period from August 2012 to April 2013. The economic analysis was done from 2 perspectives: health provider and patient. Uni-variate sensitivity analyses were conducted to assess the uncertainty in some of the variables in the model. RESULTS The evaluation study of the 3 hospitals reported 545 diarrhea patients aged below 5 years old amongst whom 311 or 57% were rotavirus positive. The societal cost to treat a rotavirus diarrhea event was estimated at US$ 661/event. With the simple model we estimated that with a vaccine coverage rate of 98%, the vaccine may avoid 47,000 rotavirus diarrhea events in the birth cohort over a period of 5 years. The estimated cost offset is around US$ 2 million. From a health care perspective including only direct medical cost the incremental cost-effectiveness ratio (ICER) with a vaccine price of US$ 27 per course was US$ 8,972 per QALY gained. This result is below the Libyan Gross Domestic Product (GDP) per capita of US$ 10,132. From a societal perspective the analysis shows cost savings of around US$ 16 per child in the birth cohort. CONCLUSIONS The economic model shows that rotavirus vaccination could be an economically attractive intervention for Libya when compared with no vaccination.