Introduction - In Mayotte, a French island in the Comoros archipelago in the Indian Ocean, fecal-oral infections remain a major public health problem. In this context, we describe the epidemiological, clinical, and biological characteristics of typhoid fever cases diagnosed in Mayotte in 2007 and 2008. Results - During these two years, 73 cases of typhoid fever were diagnosed. Nineteen cases were part of an outbreak that occurred in Mamoudzou between October and November 2008, the source of which could not be identified. The vast majority of sporadic patients lived in substandard housing without direct access to water and without proper sanitation. Patients under 25 years of age accounted for 75% of cases. The average time from symptom onset to diagnosis was 6.6 days. Of the 73 patients, 18 developed complications (6 cases of gastrointestinal bleeding, 2 cases of intestinal perforation, 4 cases of biliary complications, 5 cases of cardiac complications, and 1 case of pancytopenia). No resistant strains of Salmonella Typhi were isolated. There were no deaths. We present the laboratory findings. Discussion—We compare the situation with that of other French territories and discuss the benefits of typhoid vaccination. Conclusion - The fight against typhoid can only be won through improvements in living conditions, likely combined with vaccination. (R.A.)