We herein report a case of severe acute cholangitis complicated by bacterial meningitis. A 56-year-old Japanese man was admitted to our hospital due to a consciousness disorder that had developed while he was being treated for acute cholangitis. The levels of both hepatobiliary enzymes and inflammatory markers were high, and computed tomography revealed common bile duct stones and cholangiectasis. A diagnosis of acute cholangitis was made, and meningitis was subsequently confirmed on a cerebrospinal fluid analysis. The patient recovered successfully after receiving emergency endoscopic drainage and antibiotic therapy. This case demonstrates that a disturbance of consciousness complicated by acute cholangitis may result from septic encephalopathy as well as meningitis via bloodstream infections.