Abstract Invasive pneumococcal disease (IPD) causes considerable morbidity and mortality among children worldwide. This review describes the burden of disease and pneumococcal serotypes/serogroups causing disease in children in the Arabian Peninsula and Egypt identified from a literature search from 1990 to 2007. The incidence of IPD in children aged ≤5 years ranged from 3.4 to 53.5 per 100 000. Bacteraemia cases were responsible for 61–100% (children <2 years) of total IPD. Pneumococcal meningitis cases ranged from 3% to 25% (<2 years) and from 7% to 30% (≤5 years). The most common IPD serotypes/serogroups were 14, 23F, 6B, 19F and 6A (≤5 years). Circulating serotypes/serogroups causing IPD potentially covered by the 7-valent pneumococcal conjugate vaccine (PCV-7) ranged from 49% to 83% (<2 years) and from 61% to 69% (≤5 years). Penicillin resistance among invasive isolates ranged from 0% to 78%. Case fatality and morbidity rates for pneumococcal meningitis were 0–22% and 10–62%, respectively. Incidence and morbidity data for meningitis and bacteraemia demonstrate a substantial vaccine-preventable burden of IPD in young children. Standardisation of definitions and development of improved regional surveillance/reporting would enable the region to measure better the impact of prevention strategies for IPD, such as infant-based immunisation programmes.