Cryptococcal infections are usually described in immunosuppressed patients, but have also been described in patients with cirrhosis. We report a case of cryptococcal meningitis in a 62 year old man with Child class C alcoholic cirrhosis. Clinical signs associated mental confusion and discrete meningeal stiffness without fever. Diagnosis was confirmed by lumbar puncture which identified specific antigens and isolated Cryptococcus on Sabouraud medium. In patients with cirrhosis, cryptococcal meningitis infection should be considered in cases of isolated and unexplained mental confusion.