Congenital cytomegalovirus disease is an unsolved public health problem, unlikely to be solved by means other than immune prophylaxis. Development of a vaccine has been hampered by low awareness of the problem, which is caused by the often delayed detection of abnormalities after birth. Nevertheless, cytomegalovirus vaccine development is active. An attenuated, live vaccine has been studied extensively, and an improved strain may result from genetic manipulation. An immunogenic viral glycoprotein (gB) vaccine is currently in clinical trial to determine if antibodies alone will be protective. The idea of a combined vaccine has been proposed, in which a canarypox recombinant containing several cytomegalovirus genes is used both to generate cellular immunity and to prime for augmented antibody responses to the viral glycoprotein. Finally, DNA plasmids containing cytomegalovirus genes are being investigated for their utility as vaccines.