Gonorrhoea is a global health concern exacerbated by rising antimicrobial resistance. Retrospective analyses indicate that outer membrane vesicle (OMV) vaccines derived from Neisseria meningitidis (MeNZB, 4CMenB) may offer partial cross-protection against gonococcal infection. This review outlines the influence of gonococcal population biology on coverage, immune responses elicited by 4CMenB, and emerging strategies that offer the prospect of rationally designed vaccines dedicated to the prevention of gonococcal disease.