The risk of developing invasive pneumococcal disease in transplant patients is estimated at 28 to 36 per 1000 patients/year according to the type of organ transplanted. This rate is much higher than the estimated incidence in the general population. This study reviews the current experience regarding the different types of vaccinations against Streptococcus pneumoniae in transplant patients, the immunogenic response to pneumococcal vaccine in these patients, the clinical experience to date with the use of pneumococcal vaccines, and the utility of a sequential vaccination regime including the heptavalent vaccine and vaccine for the 23 serogroups. The immunogenicity produced by pneumococcal vaccines in transplant patients is lower and not as long-lasting as in immunocompetent individuals, and the revaccination regimen inducing the most favorable immunological response is unknown. Nonetheless, pneumococcal vaccination provides clear benefits to transplant recipients and should be given before transplantation whenever possible.