OBJECTIVES To assess the cost-effectiveness and cost-utility of adjuvanted HPV-16/18 vaccination at 12-years of age on top of the current cervical cancer (CC) screening program in five Latin American countries (Argentina, Brazil, Chile, Mexico, and Peru). METHODS A one-year cycle Markov cohort model with a lifetime horizon from the healthcare payer perspective is calibrated with local epidemiology data. The model estimates the changes in pre-malignant lesions, CC cases, deaths, life years and QALYs saved due to vaccination of a single age-cohort. Efficacy parameter values for the base-case with sensitivity analysis are: vaccine efficacy for types HPV-16/18: 95% (95%CI: 87.4-98.7%); cross-protection against HPV-31 and HPV-45: 60% (95%CI: 20.5-80.7%) and 78% (95%CI: 39.3-93.4%) respectively. We discounted both long-term costs and benefits at 3%, and report in 2007 USD($). One-way sensitivity analysis is performed for achievable screening coverage, HPV-16/18 prevalence in cervical cancer, vaccine efficacy, age of vaccination (12-18 years), vaccine cross-protection or waning. RESULTS HPV-16/18 vaccination is predicted to produce a considerable reduction on CIN II and III lesions [range: 62.8%(Brazil) - 73.5%(Argentina)], CC cases [range: 62.7%(Brazil) - 73.6%(Argentina)] and CC deaths [range per 100,000 vaccinated women: 235(Chile) - 761(Peru)]. Life expectancy per vaccinated woman increases from 17 days (Chile) to 62 days (Peru) (undiscounted values). The ICER per QALY saved is $5,964 in Argentina, $10,181 in Brazil, $17,666 in Chile, $10,134 in Mexico and $4,576 in Peru. All countries presented an ICER that is below the 3 GDP per capita thresholds. Results are most sensitive to the discount rate in all countries, and robust to all other parameters. CONCLUSIONS Universal mass vaccination against HPV-16/18 is cost-effective in the current healthcare setting of each country, with a significant impact on the wellbeing of the population with a substantial number of cervical cancer cases and deaths avoided.