Acute bacterial meningitis is an infection of leptomeninges, with involvement of subarachnoid space and parenchyma of the brain. Despite the widespread use of protective immunization coverage in the western world, acute bacterial meningitis is still a serious disease which not only takes the lives of so many children but leave them deaf, blind, handicap and crippled, creating a lot of problems for the family and country. It is responsible for 3 – 5% of pediatric hospital admission in this part of the world. Early recognition, prompt supportive treatment and antibiotic coverage not only decrease the mortality but also reduce the acute complications and long term morbidity. Acute bacterial meningitis is a common and serious infection in children resulting in significant acute complications and long term morbidity. In next millennium our success will depend upon scrutiny for antibiotic resistance, development of new antimicrobial agents and effective vaccination strategies which has reduced disease burden in developed countries.