For more than 20 years, the annual incidence rate of invasive meningococcal disease (IMD) in France has ranged from 1 to 2 cases per 105 inhabitants. It increased between 1996 and 2003 and has remained stable since 2004. Epidemiological surveillance of IIM relies on mandatory reporting and the characterization of invasive strains by the National Meningococcal Reference Center. Here we present recent trends in the epidemiology of IIM in France and describe the cases that occurred in 2006 and were analyzed by the InVS. In 2006, 716 IIM cases were reported, corresponding to an incidence rate, adjusted for underreporting, of 1.3 per 105. The highest incidence rates were observed among children under 1 year of age (14.8/105), those aged 1–4 years (4.8/105), and those aged 14–19 years (2.7/105). Among IIM cases with a known serogroup, 64% were serogroup B, 28% were serogroup C, 3% were serogroup W135, and 3% were serogroup Y. The number of serogroup C IIM cases increased by 10% between 2005 and 2006. Severe clinical forms, primarily purpura fulminans, accounted for 26% of cases. The case-fatality rate for IIM was 10%, a level that has remained stable since 2003. The case-fatality rate was higher in cases with fulminant purpura (25%) than in those without (4%, p<0.001). Deaths were more frequent among patients aged 50 and older in cases of serogroup B IIM (20%) and exceeded 15% among children under 1 year of age, those aged 5–14, and those aged 50 and older in cases of serogroup C IIM. In early 2006, an epidemic of serogroup C IIM occurred in a municipality in the Yonne department and led to a vaccination campaign for those under 20 years of age using a conjugate vaccine. In Seine-Maritime, to control the hyperendemic spread of serogroup B IIM linked to the circulation of a B:14:P1.7,16 belonging to the ST-32 clonal complex, a vaccination campaign using the MenBvac® vaccine was launched in June 2006, starting with children aged 1 to 5 living in three cantons in the Dieppe region. (R.A.)