We developed a stochastic simulation model to evaluate the impact of Escherichia coli O157:H7 (O157) vaccination on key epidemiological outcomes. The model evaluated a reduction in the O157 prevalence in feedlot cattle as well as concentration in cattle feces due to vaccination. The impact of this reduction on outcomes at slaughter/harvest and consumption was evaluated by simulating the relationships between the O157 prevalence and concentration at various points in the ground beef supply chain. The uncertainty and variability associated with the O157 contamination was explicitly modeled in production, slaughter, and consumption modules. Our results show that vaccination can have a significant benefit with respect to relevant outcomes such as (1) the number of human O157 illnesses due to the consumption of ground beef, (2) the number of production lots with high O157 contamination levels, (3) the likelihood of detection by U.S. Department of Agriculture Food Safety and Inspection Service testing, and (4) the probability of multiple illnesses due to ground beef servings from the same lot. These results show that these outcomes are strongly impacted by preharvest vaccination. For example, if the vaccine is used so as to reduce the prevalence of E. coli shedding cattle by 80% and if all U.S. steers and heifers were vaccinated, the expected number of human illnesses from ground beef-associated O157 would be reduced almost 60%. If the vaccine is 60% or 40% effective, the illness rate would be reduced approximately 45% or 40%, respectively. The number of production lots (10,000-lb lots) with high O157 contamination levels (>1000 servings) would be reduced by 96% if all steers and heifers received an 80% effective vaccine regimen. The analysis shows that resulting reduction in the number of shedding animals and the reduced concentration of E. coli on carcasses can combine to reduce human illnesses and cost to beef packers.