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Rotavirus Gastroenteritis Hospitalizations Among Under-5 Children in Northern India. OBJECTIVE: To study epidemiological profile, prevalence, and molecular epidemiology of RVGE in hospitalized under-5 children at a tertiary care teaching rural hospital located in sub-Himalayan belt of Northern India. METHODS: This was a hospital-based surveillance study done over 4 y (2016-2019) including under-5 children hospitalized with acute gastroenteritis (AGE). Demographic and clinical parameters were recorded in a pre-designed performa. After consent, stool samples were collected and sent to Christian Medical College (CMC), Vellore for RV screening by enzyme immunoassay (EIA). Each EIA-positive sample was further subjected to G and P typing using published methods. RESULTS: Out of total 851 included children, rotavirus gastroenteritis (RVGE) was detected in 23.03% (196/851) cases by EIA. The highest incidence for RVGE-positive cases (40.43%) was observed in 2016 with gradual decline over next 3 y. Maximum cases of diarrhea were observed in 12-23 mo age group along with highest rotavirus detection. G3P[8] was most common genotype (46.94%) found, followed by G1P[8] (13.78%), G2P[4] (4.59%), G1P[6] (8.16%) and G9P[4] (3.57%). Mixed genotype was seen in 13.78% of total cases. CONCLUSION: This study summarizes the changing trends in the epidemiology of RVGE in Northern India along with the major circulating genotypes postvaccine introduction.