OBJECTIVES: Meningococcal disease (MD) is a serious public health problem worldwide. It mainly affects low-income countries with higher impact in the ‘meningococcal belt’ located at the African Sub Sahara. Children younger than 5 years old are the most affected age group, with the highest incidence in the first year of life. Our aim is to evaluate the cost-effectiveness of the introduction of routine vaccination with a tetravalent meningococcal conjugate vaccine (MCV-4) in the Colombian EPI.  METHODS: An age-dependent Markov model, which followed a cohort of children under one year of age up to their life expectancy, was developed. Parameters of occurrence and care costs were based on data from National Surveillance System, official data sources, and literature review. Serotype coverage was taken from SIREVA NM Colombia surveillances from 2007 to 2010. A 3 + 1 schedule and a vaccination price of US$ 30.00 per dose were assumed in the base case, compared against no vaccination (only treatment the disease). All cost are expressed in 2011 US dollars. RESULTS: Introduction of MCV-4 would avoid 34 cases of meningococcal meningitis (MM), 27 cases of meningococcal sepsis, and 10 deaths in the lifespan of each infant’s cohort evaluated. MCV-4 vaccination avoids 126 years of life (LY), or 165 disability adjusted life years (DALYs). Vaccination would costs raises to US$ 71 million. The ICER of vaccination strategy compared to no vaccination was estimated at US$ 441,998, which is very higher than the Colombian GPD (US$ 6,883).  CONCLUSIONS: Routine vaccination against Neisseria meningitides with MCV-4in Colombia would not be cost-effective with tetravalent conjugate vaccine in the base case analysis.