Meningococcal C conjugate vaccine was introduced in the UK in November 1999 together with a comprehensive meningococcal surveillance strategy to support and inform the vaccine programme. These surveillance data have provided important information on the long-term effectiveness of the programme, through direct and indirect protection, and on the prevalent serotypes and serosubtypes causing invasive meningococcal infection subsequent to vaccine introduction. The MCC immunization programme has been extremely successful in controlling serogroup C disease and continues to be evaluated. The aim of this paper is to review the experiences in England and Wales over the past 9 years.