OBJECTIVES: Recently published efficacy data for 13-valent pneumococcal conjugate vaccine (PCV13) and 23-valent pneumococcal polysaccharide vaccine (PPSV23) provides an opportunity to update prior economic evaluations of pneumococcal vaccination in Colombia. This study aims to examine the public health impact and cost-effectiveness of PPSV23 versus PCV13 to prevent adult pneumococcal diseases in Colombia. METHODS: We applied an economic model that incorporated costs, health outcomes, and quality-adjusted life-year losses associated with invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NBPP) in a cohort of 65-year-old adults in Colombia. From the payers perspective, we evaluated the public health impact and cost-effectiveness of three strategies: no vaccination, PPSV23, PCV13. Vaccine effectiveness was based on recently published efficacy data and vaccine costs were based on the 2015 PAHO (Pan American Health Organization) reported price.  All other costs and utilities were based on literature. RESULTS: PPSV23 was more effective than PCV13 in reducing pneumococcal disease and the associated costs in 65-year-old adults in Colombia. Specifically, PPVSV23 reduced IPD cases by 20.0%, NBPP cases by 12.4%, IPD deaths by 16.5%, and NBPP deaths by 10.3%; PVC13 reduced IPD cases by 17.0%, NBPP cases by 9.8%, IPD deaths by 14.8%, and NBPP deaths by 8.6% (all versus no vaccination). From an economic perspective, both PPSV23 and PCV13 were cost-saving relative to no vaccination. However, vaccinating adults with PPSV23 reduced costs more than PCV13. The most influential parameters in the analysis were vaccine effectiveness against NBPP and the duration of vaccine protection. PPSV23 is a less costly and more effective vaccination strategy than PCV13 when the degree of vaccine protection for PPSV23 against NBPP is greater than 30% and the duration of vaccine protection is the same. CONCLUSIONS: PPSV23 is a more effective and less costly vaccination strategy than PCV13 for adults 65 years of age in Colombia.