Introduction - For more than twenty years, the annual incidence rate of invasive meningococcal disease (IMD) has ranged between 1 and 2 cases per 100,000 inhabitants. The results of epidemiological surveillance for the year 2010 are presented here. Materials and Methods - Epidemiological surveillance of IIM in France is based on mandatory reporting (MR) data submitted to the French Institute for Public Health Surveillance and on the results of typing of invasive strains by the National Reference Center for Meningococci. The estimated completeness rate of MR in metropolitan France has been estimated to be over 90% since 2005. Results - The overall incidence of IIM has been declining since 2008. In 2010, 522 cases were reported, including 510 in mainland France, resulting in an incidence rate adjusted for underreporting of 0.89 per 100,000 inhabitants. The age groups most affected are children under 1 year of age, those aged 1–4 years, and those aged 15–19 years. The decline in incidence between 2009 and 2010 was significant for IIM linked to serogroup C. Serogroup B remains predominant in France (74% of cases). The incidence of W135 IIM remained stable. Serogroup Y increased but did not exceed 5% of cases. The case-fatality rate for IIM in 2010 was 10% (53 deaths). The proportion of reported cases with purpura fulminans was 26% (130 cases), with a case-fatality rate of 23% for these cases compared to 6% for the others (p<0.001). In 2010, 55% of circulating invasive strains belonged to three clonal complexes (ST-41/44, ST-32, and ST-11). Conclusion - In France, IIM remains predominantly linked to serogroup B meningococci; the decline in the incidence of serogroup C IIM began in 2003 and is expected to continue due to the introduction of the meningococcal C conjugate vaccine into the vaccination schedule in 2010. (R.A.)