OBJECTIVES: The most common infections due Streptococcus pneumoniae are: otitis, Pneumonia, meningitis and sepsis. The aim of this study was to estimate the direct and indirect costs of pneumococcal diseases, in population under 5 years old in Colombia METHODS: Direct costs were determined from 2 sources: costs information for 2012 from a Health Medical Organization (HMO) with national coverage and the construction of cases-type based on clinical practice guidelines, through bottom-up methodology: the generating cost events were identified, validated with medical experts and valued according to tariff manual SOAT 2013. Indirect costs were related to mortality and sequelae caused by pneumococcal diseases. Mortality was estimated in terms of years of potential life lost (YPLL) based on the YPLLipc model (Gardner and Sanborn). Sequelae were measured in life years saved:  disability-adjusted life years and the years of life lost to premature death. The cost estimation was done from the perspective of third-party payer. Costs were expressed in 2013 Colombian pesos (~1927 Colombian Peso per 1 USD). RESULTS: Taking into account the HMO information, the average cost of medical attention for Acute Otitis Media was $150,274 per outpatient case and $1,514,030 per inpatient case, for pneumonia $201,969 per outpatient case and $2,238,235 per inpatient case, for meningitis and sepsis $371,006 per outpatient case and $7,446,978 per inpatient case, for hearing loss $821,857 and for mastoiditis $206,473. Taking into account the cases-type information, the average cost of medical attention for Acute Otitis Media was $109,386 per initial case and $890,296 per recurrent case, for pneumonia $569,643 per mild case and $4,310,895 per severe case, for meningitis and sepsis $10,792,183 per case, for hearing loss $1,323,775 and for mastoiditis $535,692. The costs of YPLL were $12,014,669 CONCLUSIONS: Pneumococcal diseases cause a high economic impact on public health resources, due the incidence of diseases.