Objective To describe the occurrence of Zika virus disease and its complications in the state of Tocantins and in its capital, the city of Palmas. Methods This was a descriptive study using data from health information systems. Results Incidence of reported Zika virus disease cases in 2015 and 2016 was 295.2/100,000 inhabitants and 411.1/100,000 inhab. in the general population, and 5.9/1,000 and 27.8/1,000 live births, respectively. Higher risks occurred in women, the 20-39 year age group, municipalities in the central and northwestern regions of the state and in hotter months (February and March). Incidence of Zika-related microcephaly during pregnancy was 0.06/1,000 live births. One case of Guillain-Barré Syndrome resulting from Zika virus infection was confirmed. Conclusion Zika virus disease hit Tocantins intensely, although its adverse outcomes were less frequent than in other states.