OBJECTIVES: A pentavalent rotavirus vaccine to prevent rotavirus gastroenteritis (RVGE) in children will soon become available. The objective of the study reported here was to assess the health outcomes and the economic impact in the UK of a RV vaccination programme vs no programme. METHODS: A birth cohort was followed up to age 5 using a cohort model. Epidemiological parameters were taken from the REVEAL study (a prospective epidemiological study conducted in the UK, 2004-2005) and from literature. Costs were assessed from NHS and societal perspectives by combining health care resource utilization collected in REVEAL study and unit costs from official sources. Efficacy of the vaccine was taken from a large worldwide clinical trial (70,000 children). Health outcomes included home care cases, telephone consultations, GP/Accident&Emergency department visits, hospitalisations and nosocomial infections. A sensitivity analysis was performed varying the cost of the RV vaccine course between £80 and £100. RESULTS: The model estimates that the introduction of a RV vaccination programme with the pentavalent RV vaccine (90% coverage rate) would reduce the RVGE burden by 70% in the UK: 93,800 home care cases, 23,400 telephone consultations, 76,300 GP visits, 5,300 Accident&Emergency department visits, 12,000 hospitalisations and 4,200 nosocomial infections could be avoided. The RVGE cost was estimated at £29m and £68m from NHS and societal perspectives respectively. The introduction of a RV vaccination programme would reduce the RVGE cost by 70% in both perspectives. For a vaccine course ranging from £80 to £100, the RV vaccination programme is associated with an incremental cost-effectiveness ratio that varies from £2640 to £3,710 and from £310 to £1390 per hospitalisation averted from NHS and societal perspectives respectively. CONCLUSION: This study suggests that a RV vaccination programme would have a substantial impact in reducing the important burden of RVGE and associated costs in the UK.