During the period 1985-1990, Streptococcus pneumoniae was isolated form 97 patients with systemic pneumococcal disease in Northern Norway. Systemic disease occurred most frequently in the age groups 0-4 years and > 60 years. An increasing incidence was observed, especially among children less than five years old. Serotypes covered by the 23-valent pneumococcal polysaccharide vaccine were found in 86 of 97 (88.7%) isolates. The vaccine did not cover 16.7% of the systemic isolates from children less than five years old. Reduced sensitivity to penicillin was found in one isolate (1.0%) which was resistant to ampicillin, doxycycline and chloramphenicol. The E-test and the Rosco agar diffusion test differed in sensitivity to penicillin, chloramphenicol, ciprofloxacin and erythromycin. Three serotype 12F strains showed unusual cross-resistance to chloramphenicol and erythromycin.