OBJECTIVES To assess the potential impact of universal vaccination with RV5 on healthcare burden and costs associated with rotavirus gastroenteritis (RGE) among a hypothetical birth cohort of 21,938 Slovenian children in their first five years of life METHODS A Markov model was used to evaluate the cost per quality-adjusted-life-year (QALY) and public health impact of vaccination with RV5 from the healthcare payer and societal perspectives. The base case assumes three dose coverage rate of 94% at 2, 4 and 6 months among the vaccinated, the remaining receiving 1 or 2 doses. In the absence of universal vaccination 819 hospitalizations and 3,276 office visits were projected to occur in the first 5 years of life. RGE associated costs include direct and indirect costs associated with parental work loss. The efficacy of RV5 in reducing healthcare resource utilization is based on the results of the Rotavirus Efficacy and Safety Trial (REST). RESULTS A universal RV5 vaccination program is projected to reduce hospitalizations, office visits and parental work loss by 94, 76 and 87% respectively. The cost per case avoided would be 165 Euros, and cost per hospitalization avoided would be 1,639 Euros with implementation of universal vaccination. The cost per QALY saved would be 29,452 Euros and 20,453 Euros from the healthcare and societal perspectives respectively.  CONCLUSIONS RV5 is projected to avert substantial number of RGE hospitalizations and office visits in Slovenia and would be considered a cost effective intervention. KEYWORDS: rotavirus vaccine, cost effectiveness, QALY