Epidemics of bacterial meningitis caused by Neisseria meningitidis were first reported in Brazil in 1920.Following the predominance of meningococcal serogroup B during the 1990s, serogroup C outbreaks emerged throughout Brazil after 2000, gradually replacing B as the most prevalent serogroup. During the first semester of 2010, unusually high numbers of meningococcal disease cases and deaths among persons older than 10 years occurred in the city of Salvador, leading the state immunization program to conduct mass vaccination of city residents 10 to 24 years of age from May to August 2010. We analyzed data from meningitis surveillance in Salvador in 2010