Rotaviruses are the commonest cause of severe watery diarrheal disease in infants and young children, causing an estimated 352,000-592,000 deaths per year, mostly in developing countries. In 1999, the first rotavirus vaccine to be licensed in the USA (RotaShield) was withdrawn . However, before use of the vaccine was suspended, several economic evaluations were performed. Recently, two rotavirus vaccines, Rotarix and RotaTeq, have completed Phase III clinical trials. The first economic evaluations of these new rotavirus vaccines are now appearing. The purpose of this paper is to review the existing cost-effectiveness evidence-base, and to provide methodologic suggestions for future analyses.