OBJECTIVES: . In 2009, it was estimated that there were 12.000 to 28.000 deaths in Latin America related to Streptococcus pneumonia infections in pediatric population under 5 years old.  Currently, in El Salvador, Prevenar 7 (PCV-7) is the anti-pneumococcal vaccine used.  The aim of this study was to estimate the cost-effectiveness and cost-utility of immunization strategies based on pneumococcal conjugated vaccines (PCVs) in El Salvador, from an institutional perspective.  METHODS: . A decision tree model was used to asses economic and health impact of PCVs in children under 2 years old.  The alternatives compared were: no vaccination (comparator), PCV-7, PCV-10 and PCV-13.  The effectiveness measures were: child illness avoided, life years gained (LYs) and quality-adjusted life years (QALYs) gained.  Effectiveness and utilities were obtained from literature.  Local costs (expressed in 2009 $US) and epidemiology (data from 2009) were obtained from El Salvador´s Ministry of Health database.  The model included vaccine dosage schedules approved in WHO prequalification and/or El Salvador MoH calendar at the time of data collection (dec-2010).   Univariate sensitivity analysis was performed.  The time horizon was one year and the discount rate was 3%.  RESULTS: . Results show that immunization is cost-saving against no-vaccination.  PCV-13 gained the highest number of QALYs (898) against PCV-10 (637) and PCV-7 (460).  PCV-13 prevented 359 illnesses and gained 998 LYs.  PCV-10 and PCV-7 prevented 257 and 228 illnesses and gained 707 and 511 LY´s, respectively.  These results were robust to variations in herd immunity and impact adjustments of PCV10 immunogenicity.  CONCLUSIONS: .  In El Salvador, immunization strategies based on 7, 10 and 13-valent PCV´s would be cost-saving interventions.  Health outcomes and savings of PCV-13 are greater than those estimated for 7 and 10-valent PCV´s.