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Rotavirus (RV) is the leading cause of acute gastroenteritis (GE) among infants and young children worldwide. However, little is currently known concerning the specific burden of RVGE in Central and Eastern Europe (CEE). This study was undertaken to asses the burden of RVGE among children aged <5 years in 7 CEE countries (Czech Republic, Hungary, Poland, Romania, Russia, Slovakia, and Slovenia).Data relating to the incidence of total GE and RVGE (including associated hospitalizations and mortality) were retrospectively collected between 1998 and 2003 and analyzed individually for each country and collectively using the ‘pyramid’ model of disease burden established by Parashar.Although limited by differences in methods of reporting and data collection between countries, available data clearly demonstrate the clinical significance of RVGE in CEE. RV accounts for up to 55.3% of all GE hospitalizations in children aged <5 years in this region. G1 seems to be the most common circulating RV type, followed by G3 and G9. Death caused by RV is rare in CEE, reflecting appropriate disease management. Although specific health economic data are lacking, the high rate of hospitalization caused by RVGE in CEE countries is likely to be associated with significant direct and indirect public health costs.Prevention of RV disease through routine childhood vaccination would be expected to reduce the substantial burden of acute GE disease among infants and young children in CEE, primarily through a reduction in the number of RV-related hospitalizations, with associated reductions in both medical and social costs.