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Background: <i>Streptococcus pneumoniae (S. pneumoniae)</i> and <i>Hemophilus influenzae (H. influenzae)</i> are among the main vaccine-preventable bacterial infections in immunocompromised individuals including solid organ transplant (SOT) recipients. There is a lack of information about incidence and outcomes of these infections in SOT recipients. Methods: We determined the incidence of <i>S. pneumoniae</i> and <i>H. influenzae</i>, the related hospitalization, and 30- and 180-days mortality in a large cohort of 1182 adult SOT recipients. We calculated 95% confidence intervals (CI) of incidence rate (IR) using Byar’s approximation to the Poisson distribution. Results: The overall IR of <i>S. pneumoniae</i> and <i>H. influenzae</i> were 1086 (95% CI, 796–1448) and 1293 (95% CI, 974–1687) per 100,000 person-years of follow-up (PYFU), respectively. The IR of invasive infections were 76 (95% CI, 21–202) and 25 (95% CI, 2.3–118) per 100,000 PYFU, respectively. Hospital admission was required in >50%, 30-days mortality was 0, and 180-days mortality was 8.8% and 4.5% after <i>S. pneumoniae</i> and <i>H. influenzae</i> infections, respectively. Conclusions: The IR of invasive <i>S. pneumoniae</i> and <i>H. influenzae</i> infections in SOT recipients were much higher than reports from the general population in Denmark. Furthermore, a large proportion of infected SOT recipients were hospitalized. These findings highlight the need for further studies to assess uptake and immunogenicity of vaccines against <i>S. pneumoniae</i> and <i>H. influenzae</i> in SOT recipients.