Streptococcus pneumoniae is the leading bacterial pathogen of infectious diseases in children and adolescents. The 23-valent pneumococcal polysaccharide vaccine could prevent invasive pneumococcal infection with broader serotype coverage but still has some limitations. On the other hand, 7-valent pneumococcal conjugate vaccine has been shown to decrease cases of nasopharyngeal acquired S. pneumoniae vaccine serotypes and proved herd immunity. The safety and efficacy against vaccine serotype pneumococcal diseases have been documented. However, the potential risk of increasing non-vaccine serotype pneumococcal diseases should be considered. This article reviews the current status of pneumococcal disease and pneumococcal vaccines. We also review the current situation of pneumococcal infections and vaccines in Taiwan. Surveillance of disease burden and clinical isolates should be continued.