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Currently, pneumococcal infections are a public health problem. Streptococcus pneumoniae is a leading cause of community acquired invasive and non invasive bacterial infections in infants and young children, more specifically among those under five years. Pneumococcal invasive infections, in particular meningitis, carry a mortality upper than 8 % and a high risk of sequelae. Atypical clinical expression is frequent in youngest children. Membrane immunochromatography for rapid detection of urinary C-polysaccharide antigen is one of the advances for biological diagnosis, but it remains to be evaluated in children. Due to the increasing prevalence of penicillin-resistant pneumococci, treatment has to be adapted to clinical and epidemiological features. Frequent, serious, antibiotic-resistant characters of pneumococcal infections plea for vaccine. In France, Pneumo 23® indications were extended in 1998, and pneumococcal conjugate vaccine Prevenar® indications were modified in 2002. Local, national and international surveys are needed to adapt treatment and vaccine strategies.