This study analysed notification data from the first year of enhanced surveillance of invasive pneumococcal disease (IPD) in Victoria (1 July 2001 - 30 June 2002), with a focus on risk factors for infection and vaccination status among children under five years of age. Overall, there were 397 notifications (8.2 per 100,000 population), 131 (33%) were children under five years of age. The highest notification rates were among those aged less than two years (72.6 per 100,000 population). Among children aged less than five years: bacteraemia without a primary focus of infection was the most common clinical presentation (64%); 89 per cent were hospitalised with the median length of stay being three days; four children (3%) died. There were 107 cases of a known serotype, 92% (n = 98) were either in or closely related to those included in the 7-valent conjugate pneumococcal vaccine (7vPCV). Most cases (98%) were not eligible for free 7vPCV under the currently funded program in Victoria. Only one child had been vaccinated. The results from the first year of enhanced IPD surveillance in Victoria suggest consideration should be given to extending the publicly funded program to include all children under two years of age.