Despite advances in antibiotic treatment, bacterial meningitis remains a significant cause of mortality and morbidity among children. In population-based studies in the United States, the incidence of bacterial meningitis is estimated to be 4.6 to 10 per 100,000 population per year. Every year more than two thousand deaths due to bacterial meningitis are reported in the United States, most of these in previously healthy children. This article reviews diagnosis and management of this puzzling disease entity.