OBJECTIVES: To evaluate the cost-effectiveness results of introducing PCV7 into City Immunization Programs in 7 urban China. METHODS: Six health status contained pneumococcal meningitis (inpatient), pneumococcal septicemia (inpatient), pneumonia (all-cause, inpatient), pneumonia (all-cause, outpatient),  mild otitis media (all-cause, outpatient) and sever otitis media (all-cause, outpatient )were considered.  Age-specific cost was collected from electronic patient records (2010) from 14 hospitals in 7 cities in China. Two hospitals in each city was selected (1 Children’s Hospital, 1 Comprehensive Hospitals) and 7 field cities including Beijing, Guangzhou, Shenzhen, Wuhan, Xi’an, Chengdu and Shenyang were enrolled. Direct medical cost included registry fee, medications, diagnostic tests fee, and hospitalization expenditure.  A discount rate of 5% was applied. One-way sensitivity analyses were performed to evaluate the sensitivity of the results to data inputs. RESULTS:  As Category II vaccinePCV7 was not cost effective due to the private market unit price and low penetration rate. However, vaccination of children under 2 years old from 7 urban China in a CIP is estimated to prevent 366,337 cases from infection and 3,415 cases from death compared to no vaccination.  From a payer perspective, a PCV7 CIP had an ICER of RMB17, 977/QALY in Beijing, RMB79,180/ QALY in Chengdu, RMB72,406/QALY in Guangzhou, RMB70,896/QALY in Shenyang,RMB69,792/QALY in Shenzhen, RMB64,152/QALY in Wuhan and RMB76,864/ QALY in Xian. CONCLUSIONS: The empirical results show that under the current situation with a 860 Yuan/ dose vaccination price and a 85% vaccination rate, when take PCV7 into the city immunization plan, the spending of the cost is worth in Beijing, Guangzhou and Shenzhen and is acceptable in Wuhan, Shenyang, Chengdu and Xi'an.