Neonatal bacterial meningitis is a serious disease around the world, with the incidence changing little in the past 30 years. Group B streptococci, Escherichia coli, and Klebsiella pneumoniae are common causative organisms and lumbar puncture remains the definitive method of diagnosis. The mortality rate has declined in industrialized countries over the years, from almost 50% in the 1970s to less than 10% in 1997. However, neurological sequelae are still frequently observed despite major changes in treatment. Preliminary analysis of our own data from a prospective study of cases in the United Kingdom suggests that treatment with third generation cephalosporins is related to a decrease in mortality but not morbidity.