During 2003-2009, substantial progress was made toward the previous goal of measles elimination in the World Health Organization (WHO) European Region (EUR) by 2010. However, since late 2009, measles virus transmission has increased, and outbreaks have become widespread. In 2011, measles outbreaks have been reported in 36 of 53 EUR member states; a total of 26,074 measles cases had been reported regionwide as of October 26. France reported the largest number of cases (approximately 14,000), predominantly among older children and young adults who had not been vaccinated or whose vaccination history was unknown. Overall, the primary reason for the increased transmission and outbreaks of measles in EUR is failure to vaccinate susceptible populations. Eliminating measles by 2015, a new measles elimination target date set in September 2010 by the 60th Regional Committee for Europe, will require 1) increasing demand for and delivery of vaccination to achieve and sustain ≥ 95% coverage with 2 doses of measles-containing vaccine (MCV) across a wide age range, 2) implementing effective outbreak control measures, and 3) further strengthening surveillance to identify cases and outbreaks promptly, and in the future, to validate elimination.