A review of laboratory-confirmed invasive meningococcal disease cases in Auckland between January 2004 and December 2020 has shown that Māori and Pasifika children are disproportionately affected, and that serogroup B is by far the most common strain. There were 319 cases of meningococcal disease in 318 children aged <15 years during the review period, of which 4.1% died and 23.6% of those with follow-up data experienced sequelae. As well as Māori and Pasifika children, those living in the most deprived areas were also over-represented. Serogroup B meningococcal disease was found in 81% of cases, serogroup W in 8.6% of cases, serogroup C in 6.3% of cases, and serogroup Y in 3.7% of cases. Bacteraemia was present in 79% of cases and meningitis in 63.9%. The New Zealand National Immunisation Schedule should include vaccination against serogroup B meningococcal disease to address health inequities for Māori and Pasifika children, concluded the study authors.