This study analysed the epidemiological trends of dengue cases and deaths in Cebu province, Philippines, recorded at sentinel hospitals of the Department of Health, Regional and Epidemiological Surveillance Unit in Central Visayas during 1997-2008. A total of 34326 dengue cases [dengue fever (DF) and dengue haemorrhagic fever (DHF)] and 831 deaths occurred in the 12-year period. The average case-fatality rate (CFR) was 2.46%; the average incidence rate of hospitalized dengue cases was 0.854/1000 population. The annual incidence rates of hospitalized DHF cases (average = 0.55 cases/1000 population; 17540 total cases) and DF cases (average = 0.323 cases/1000 population; 9977 total cases) differed (P<0.05) in 2000-2008. The incidence rates of hospitalized DHF cases were significant (P<0.05) from year-to-year in 2000-2008, whereas those of DF were mostly significant, except between 2001 and 2003 (P>0.05). Dengue cases, deaths and CFR increased annually in the rainy season. Cebu city was the highest (average = 0.356 cases/1000 population) in its yearly incidence rate of hospitalized dengue cases and differed (P<0.05) among the top 10 municipalities and cities, followed by Mandaue city (average = 0.076 cases/1000 population). Dengue cases differed (P<0.05) across age groups. One- to five-year-old (average=31.82%) and 6 to 10-year-old children (30.66%) were significantly higher compared with other age groups. Urbanization, increased population, inadequate public health infrastructure, poor solid waste management and lack of effective mosquito surveillance system were the reasons.