OBJECTIVES: To assess cost-utility of the prophylactic HPV vaccination on the prevention of ICC in brazilian amazonic region (State of Roraima). Invasive cervical cancer (ICC) remains an important public health problem, particularly in developing countries. The brazilian amazonic region is an high incidence area of ICC, comparable to low-income countries (crude incidence rate: 46/100.000), what suggests weaknesses in the current secondary prevention program. METHODS: A Markov model was developed as an analytic tool to simulate the natural history of HPV and its progress to ICC, considering the current preventive programs. Transition probabilities assumptions were based mainly on empirical data of local and national studies. The model evaluated the addition of the vaccine to 3 cervical cancer screening scenarios (0, 3 or 10 exams throughout life). RESULTS: The scenario of three Pap tests resulted in satisfactory calibration (base case). The addition of HPV vaccination would reduce by 35% the incidence of ICC, in a setting of 70% vaccination coverage. The incremental ratio of cost-effectiveness (IRCE) was R$ 1,200 for each year of quality-adjusted life (QALY) saved. The sensitivity analysis confirms the robustness of this result, and duration of immunity was the parameter with greater variation in. CONCLUSIONS:    Vaccination has a favorable profile in terms of cost-utility, and its inclusion in the immunization schedule would result in substantial reduction in incidence and mortality of ICC in amazonic region of Brazil.