Bacteroides fragilis is a rare cause of bacterial meningitis. In the antibiotic era nine cases have been reported. Seven of these nine cases occurred in premature infants and neonates. Of the nine patients with B. fragilis meningitis, two died, four survived with neurologic sequelae, and three survived without sequelae. Predisposing conditions included abdominal sepsis, chronic otitis media, and ventriculoatrial shunt infection. Metronidazole, which is bactericidal, has been the most effective therapy for B. fragilis meningitis.