Ralstonia mannitolilytica is a difficult-to-diagnose, aerobic, Gram-negative bacillus, mainly causing healthcare infections in immunocompromised hosts. We report the first case of R. mannitolilytica bacteraemia in a kidney transplant recipient. Identification of R. mannitolilytica was finally performed by 16S rRNA gene sequencing. All cases of R. mannitolilytica bacteraemia reported in the English language literature over the past 20 years are reviewed to alert clinicians to the epidemiological, clinical, diagnostic, prognostic and microbiologic features of this emerging pathogen.