OBJECTIVES: To estimate direct medical cost and productivity lost for invasive pneumococcal diseases in child under 2 in 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.  2 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, and diagnostic tests fee, hospitalization expenditure. Cost of productivity lost were days for work absent of patient plus time consumed of infirmaries. In  first part, weighted average method was used to calculate average direct medical cost. In second part, daily wage rate was applied to estimate  cost of productivity lost. RESULTS: The average direct medical cost in all IPD cases (pneumococcal meningitis& pneumococcal septicemia) was 20,950 Yuan (95%CI: 4,489-101,003).  Average 19 working days lost in patients’ relatives for caring and costs of productivity lost was 1934 Yuan (95%CI: 532-6,412)  per patient. CONCLUSIONS: IPD has a serious impact on  life quality of  child under 2 in Chinese urban areas and it could lead to  severe economic burden.