Introduction - 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. Methods - Epidemiological surveillance of IIM relies on mandatory reporting and the characterization of invasive strains by the National Meningococcal Reference Center. Results - In 2008, 689 cases of IIM were reported, corresponding to an incidence rate, adjusted for underreporting, of 1.2 per 105. The highest incidence rates were observed among children under 1 year of age (13.2/105), those aged 1–4 years (5.0/105), and those aged 15–19 years (2.4/105). Among IIM cases with a known serogroup, 69% were serogroup B, 23% were serogroup C, 3% were serogroup W135, and 4% were serogroup Y. Among strains characterized by MLST (multilocus sequence typing), three clonal complexes were predominant: ST-41/44, ST-11, and ST-32. Severe clinical forms, primarily fulminant purpura, accounted for 29% of cases. The case-fatality rate for IIM was higher in the presence of purpura fulminans (23%) than in its absence (6%, p<0.001). It was higher for IIM C (26 deaths, or 19%) than for IIM B (38 deaths, or 9%, p<0.01). Conclusions - The incidence rate of IIM, which had increased between 1996 and 2003, showed a slight decrease between 2004 and 2008. In 2008, serogroup B remained predominant, and the case-fatality rate was higher for IIM C. (R.A.)