Aims: To describe trends in case notification data for vaccine-preventable diseases in NSW for 2009. Methods: Risk factor and vaccination status data was collected from cases through public health unit follow-up. Data from the NSW Notifiable Diseases Database were analysed by: area health service of residence; age; vaccination status; and sub-organism, as appropriate for the period 1991–2009. Results: The incidence of vaccine-preventable disease has declined over time. Outbreaks of measles and pertussis occur in the community, associated with unimmunised groups (measles) or as a result of waning immunity (pertussis). Conclusion: Regular reporting of vaccine-preventable disease surveillance data will help inform control strategies in NSW.