In 1999, the Ministry of Health of Kyrgyzstan adopted the goal of measles elimination. This opportunity was used to launch a rubella and congenital rubella syndrome prevention program. Between January and August 2001, a rubella outbreak occurred in Bishkek City and Chui Oblast. Rubella surveillance data were reviewed for Kyrgyzstan (1981-2000) and rubella case-patient and laboratory information from Bishkek City and Chui Oblast during the outbreak. The data suggest that rubella is endemic in Kyrgyzstan with periodic epidemics every 3-5 years. From January to August 2001, 1936 rubella case-patients were reported from Bishkek City and Chui Oblast; 242 were tested and 176 (73%) were laboratory confirmed. Most case-patients were 3-14 years old. However, the incidence rate per 100,000 among persons aged 15-35 years increased >/=40-fold from 1 in 2000 to 41 in 2001. These findings highlight the importance of introducing rubella-containing vaccine in conjunction with measles elimination activities.