OBJECTIVE: To assess the completeness of data describing Aboriginal and Torres Strait Islander status in NSW invasive meningococcal disease notifications and determine the relative risk for invasive meningococcal disease among Aboriginal and Torres Strait Islander peoples in NSW. METHODS: Surveillance data from the NSW Notifiable Diseases Database was reviewed for 5-year periods between 1991 and 2005. RESULTS: Invalid and missing data on Aboriginal and Torres Strait Islander status decreased from 42% to 8% during the study period. Higher rates of disease were found in young children and significantly higher rates in Aboriginal and Torres Strait Islander children aged 0-4 years compared with their non-Aboriginal counterparts. CONCLUSION: Aboriginal and Torres Strait Islander children in NSW experience higher rates of notified invasive meningococcal disease than non-Aboriginal children.