We used published and unpublished studies and national statistics to estimate the number of deaths, hospitalizations, and outpatient visits due to rotavirus diarrhoea and the associated national economic burden of disease in India. Annually in India, rotavirus diarrhoea causes an estimated 122,000–153,000 deaths, 457,000–884,000 hospitalizations, and 2 million outpatient visits in children <5 years of age. India spends Rs 2.0–3.4 billion (US$ 41–72 million) annually in medical costs to treat rotavirus diarrhoea. The use of specific interventions against rotavirus, such as newly available vaccines, would help prevent much of this large disease and economic burden.