Surveys carried out between 1990 and 2000 indicated that the incidence of STEC O157-associated gastroenteritis in The Netherlands was 1250 cases/year (median), of which 180 visited a general practitioner, 40 are reported and 0·6 are fatal, mainly in the elderly. There are approximately 20 cases of STEC O157-associated haemolytic–uraemic syndrome (HUS) per year, mainly in children. There are 2·5 HUS patients per year who develop end-stage renal disease (ESRD). There are an estimated 2 HUS-related and 0·5 ESRD-related fatalities per year. The mean disease burden associated with STEC O157 in the Dutch population is 116 (90% confidence interval 85–160) Disability Adjusted Life Years (DALYs) per year. Mortality due to HUS (58 DALYs), and ESRD (21 DALYs) and dialysis due to ESRD (21 DALYs) constitute the main determinants of disease burden. Sensitivity analysis indicates that uncertainty associated with model assumptions did not have a major effect on these estimates.