AIM: To analyse the epidemiology of coded rotavirus hospitalisations in Australia from 1993 to 2002, with a view to understanding the pre-vaccination burden of severe disease in Australia. This study also seeks to determine the burden of rotavirus-related mortality. METHODS: Hospitalisation data from the Australian Institute of Health and Welfare for the period 1993-2002 were analysed. Rotavirus-related mortality data from the National Mortality Database were also analysed for the period 1990-2002. RESULTS: There were an average of 4260 patients hospitalised for rotavirus each year. The majority of rotavirus hospitalisations occurred in those under the age of 5 years, with the highest rate being in those aged 6-12 months (618.4 per 100,000). The Northern Territory was the most distinct region, with exceptionally high rates of admission (148.9 per 100,000 total population), younger age of admission and longer lengths of stay. Mapping of rotavirus hospitalisation in Australia showed well-defined areas of high hospitalisation rates. Thirteen rotavirus-related deaths occurred during 1990-2002. CONCLUSION: Rotavirus infection causes considerable morbidity and mortality in Australia. A vaccination programme would need to be completed by 6 months of age to have maximal impact.