Subdural empyema is a distinct clinical entity not uncommon in Ceylon. Forty‐seven cases have been analysed. The commonest sources of infection are otitis media and frontal sinusitis. These empyemas are often complicated by cortical thrombophlebitis, meningitis and intracerebral abscesses. The symptomatology is difficult to differentiate clinically from that of other forms of intracranial suppuration. Percutaneous carotid angiography is the investigation of choice. The treatment consists of surgical evacuation of pus combined with correct antibiotic therapy and skilled nursing. Our mortality of 25·5% was due to uncontrollable associated infections, usually the result of late referral.